Annals of Gastroenterological Surgery最新文献

{"title":"Institutional learning curve and factors of prolonged operation time of robotic distal pancreatectomy: An analysis of an initial 117 cases","authors":"Yuki Hirata,&nbsp;Laura Prakash,&nbsp;Jess Maxwell,&nbsp;Rebecca Snyder,&nbsp;Michael Kim,&nbsp;Hop Tran Cao,&nbsp;Ching-Wei D. Tzeng,&nbsp;Jefferey E. Lee,&nbsp;Matthew H. G. Katz,&nbsp;Naruhiko Ikoma","doi":"10.1002/ags3.70005","DOIUrl":"https://doi.org/10.1002/ags3.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The granular methods by which centers can safely implement and effectively expand robotic distal pancreatectomy (RDP), including those related to appropriate patient selection during the learning curve period, remain unclear. This study aimed to verify that our strategic robotic surgical oncology program effectively implemented RDP as standard practice and to identify factors associated with prolonged operation time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We performed a detailed analysis of the intraoperative and short-term outcomes of consecutive patients (October 2018–September 2023) undergoing RDP at our center, beginning with the first patient in our program. Operation time was analyzed using a cumulative sum chart (CUSUM), and factors associated with prolonged operation time were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Throughout the study period, five surgeons performed RDP for 117 patients. The CUSUM analysis indicated our center required 18 cases to overcome the initial learning phase and 43 additional cases to become proficient. In contrast, when comparing short-term outcomes across the three observation periods, there were no significant changes in the incidence of ACCORDION grade ≥3 pancreatic fistulas (<i>p</i> = 0.684), or readmission rates (<i>p</i> = 0.457). A multivariable analysis revealed BMI ≥30 in male, the presence of pancreatitis or fibrosis, and the performance of concomitant procedures were associated with extended operation times, while BMI ≥30 in female was not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although an institutional learning curve was observed, our program enabled the safe implementation of RDP and successfully expanded the number of primary operating surgeons while maintaining stable short-term outcomes. The absence of an impact of high BMI on operation time in female patients suggests a notable advantage of robotic approach for these individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"861-869"},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520244","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":"Light-emitting diode irradiation targets aerobic glycolysis in cancer-associated fibroblasts to inhibit metabolic coupling with colon cancer cells","authors":"Masaaki Nishi,&nbsp;Chiharu Nakasu,&nbsp;Toshiaki Yoshimoto,&nbsp;Takuya Tokunaga,&nbsp;T. Hideya Kashihara,&nbsp;Chie Takasu,&nbsp;Daichi Ishikawa,&nbsp;Yuma Wada,&nbsp;Mitsuo Shimada","doi":"10.1002/ags3.70004","DOIUrl":"https://doi.org/10.1002/ags3.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The concepts examined in tumor metabolism research have been moving away from cancer cells themselves and the tumor microenvironment has become a focus of investigation. Epigenetic changes affecting glucose metabolism in cancer-associated fibroblasts (CAFs) in the tumor microenvironment regulate the malignancy of cancer cells. Light-emitting diode (LED) have several functional effects, including anti-tumor effects, through a variety of mechanisms. We previously reported that blue LED irradiation had an anti-tumor effect via Opsin 3 that suppress CAF function in vivo and in vitro. However, the detailed mechanism by which LED affect CAF regulation remained unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CAFs were induced from human intestinal fibroblasts co-cultured with colon cancer cells. Using lactate assays and reverse transcription-quantitative PCR, the effects of LED irradiation on glycolysis in CAFs were investigated. The effects of LED irradiation for metabolic coupling were evaluated in vitro.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Reverse transcription-quantitative PCR showed higher expression of CAF marker genes in induced CAFs. Blue LED irradiation of induced CAFs suppressed their ability to promote characteristics of tumor malignancy of colon cancer cell line. LED treatment decreased expression of glycolysis markers, including phosphofructokinase and monocarboxylate transporter 4, indicating inhibition of glycolytic activity in CAFs. Extracellular secretion of lactate from CAFs was decreased by LED irradiation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Blue LED irradiation targeted metabolic coupling between CAFs and colon cancer cells, thereby reducing the promotion of tumor progression by CAFs. Blue LED targeting glucose metabolism in CAFs is a promising anti-cancer treatment option.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"761-768"},"PeriodicalIF":2.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520289","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":"Perioperative outcomes of esophagectomy after doublet versus docetaxel-based triplet neoadjuvant chemotherapy in older patients: A nationwide inpatient database study in Japan","authors":"Yuki Hirano,&nbsp;Takaaki Konishi,&nbsp;Hidehiro Kaneko,&nbsp;Satoru Matsuda,&nbsp;Hirofumi Kawakubo,&nbsp;Yuya Kimura,&nbsp;Hiroki Matsui,&nbsp;Kiyohide Fushimi,&nbsp;Hiroyuki Daiko,&nbsp;Osamu Itano,&nbsp;Hideo Yasunaga,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.70000","DOIUrl":"https://doi.org/10.1002/ags3.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although docetaxel-based triplet neoadjuvant chemotherapy has yielded promising results for locally advanced esophageal cancer, there are concerns that the triplet regimen can increase perioperative adverse events in older patients. This retrospective study assessed the perioperative outcomes following doublet or docetaxel-based triplet chemotherapy and esophagectomy in older patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data of patients aged 70–79 years who received cisplatin and 5-fluorouracil (CF) or docetaxel, cisplatin, and 5-fluorouracil (DCF) before esophagectomy were extracted from a nationwide Japanese inpatient database (April 2012–March 2022). The primary outcomes were major and respiratory complications. The secondary outcomes included anastomotic leakage, 30-day unplanned readmission, and 30- and 90-day mortality. Analyses were conducted using overlap propensity score weighting, propensity score matching, and instrumental variable methods to adjust for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 5229 eligible patients, 3457 (66%) and 1772 (34%) patients received neoadjuvant CF and DCF, respectively. Major and respiratory complications occurred in 5229 (40%) and 1388 (27%) patients, respectively. After overlap weighting, DCF was not associated with a higher frequency of major (odds ratio 0.99 [95% confidence interval 0.87–1.12]) and respiratory complications (odds ratio 1.04 [0.90–1.19]) compared with CF. The frequencies of anastomotic leakage, 30-day unplanned readmission, and 30- and 90-day mortality did not differ between the groups. Propensity score matching and instrumental variable analyses yielded similar results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Neoadjuvant DCF was not associated with a higher frequency of perioperative adverse events compared with CF after esophagectomy in patients aged 70–79 years.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"687-697"},"PeriodicalIF":2.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519927","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":"Nutritional benefits of pancreas-sparing total duodenectomy for severe duodenal polyposis in patients with familial adenomatous polyposis","authors":"Ibuki Fujinuma,&nbsp;Toshiro Ogura,&nbsp;Ayano Takahashi,&nbsp;Satoshi Nomura,&nbsp;Kei Kitamura,&nbsp;Amane Takahashi,&nbsp;Takehiro Shiraishi,&nbsp;Yoshiko Mori,&nbsp;Toru Ishiguro,&nbsp;Takatoshi Matsuyama,&nbsp;Youichi Kumagai,&nbsp;Hideyuki Ishida","doi":"10.1002/ags3.12919","DOIUrl":"https://doi.org/10.1002/ags3.12919","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Severe duodenal polyposis associated with familial adenomatous polyposis considerably increases the risk of duodenal cancer. Pancreas-sparing total duodenectomy is an alternative surgical approach for managing severe duodenal polyposis. This study evaluated the postoperative nutritional outcomes following pancreas-sparing total duodenectomy in patients with severe duodenal polyposis associated with familial adenomatous polyposis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective analysis compared 28 patients who underwent pancreas-sparing total duodenectomy for Spigelman stage IV duodenal polyposis with 29 patients who underwent pancreatoduodenectomy for low-malignancy duodenal neoplasms. Patient demographics, postoperative complications, and nutritional parameters were analyzed at 3, 6, 9, and 12 months postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with patients in the pancreatoduodenectomy group, those in the pancreas-sparing total duodenectomy group were younger and had a higher incidence of previous abdominal surgeries (<i>p</i> &lt; 0.01). Postoperatively, the pancreas-sparing total duodenectomy group showed significantly better preservation of total protein, albumin, and total cholesterol levels, body mass index, body weight, and psoas major muscle area compared to the pancreatoduodenectomy group (<i>p</i> &lt; 0.05). Additionally, glucose tolerance was better maintained in the pancreas-sparing total duodenectomy group than in the pancreatoduodenectomy group (<i>p</i> &lt; 0.01), with no patients requiring the initiation of insulin therapy or experiencing the exacerbation of diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pancreas-sparing total duodenectomy effectively preserves the postoperative nutritional status in patients with duodenal polyposis associated with familial adenomatous polyposis. This surgical option maintains postoperative nutritional integrity and improves long-term outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"822-829"},"PeriodicalIF":2.9,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12919","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520259","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":"Advantages of subtotal gastrectomy for upper third gastric cancer: A systematic review and meta-analysis","authors":"Yuichiro Miki,&nbsp;Tsubasa Bito,&nbsp;Yasufumi Koterazawa,&nbsp;Shingo Kanaji,&nbsp;Hisashi Shinohara","doi":"10.1002/ags3.12913","DOIUrl":"https://doi.org/10.1002/ags3.12913","url":null,"abstract":"<p>Distal gastrectomy with very small remnant stomach (subtotal gastrectomy, STG) is sometimes performed for upper third gastric cancer, instead of total gastrectomy (TG). However, the advantages of STG over TG remain fully unknown, in terms of survival outcomes, complication rates, nutritional status, and quality of life. Therefore, a systematic review was performed in accordance with the preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension statement for reporting systematic reviews. Meta-analyses were performed regarding operation time, complication rates, body weight changes, and reflux esophagitis by using R software. Operation time was significantly shorter in STG than in TG (Mean difference: −20.79 [95% CI: −35.59 to −5.99]). We cannot conclude whether STG is better than TG in terms of survival because of inconsistency among reports. The total complication rates (≧ grade2 and 3) are significantly lower in STG than TG. Reflux esophagitis was lower in STG than in TG (0% vs. 7.7%), although the difference was not significant probably because of small sample size. Body weight change compared with preoperative value was significantly lower after STG than TG both at 6 and 12 months after the operation (6 months: mean difference −5.31% [95% CI: −6.95 to −3.67], 12 months: mean difference −6.13 [95% CI: −8.20 to −4.06]). We revealed that STG has its advantage on shorter operation time, less complication rates, and lower body weight loss by meta-analysis. Although there are some controversies, STG can be an ideal option for patients with gastric cancer of upper third stomach.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"650-657"},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12913","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520246","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":"Osteopenic occult vertebral fracture is associated with poor oncological outcome in patients with hepatocellular carcinoma after hepatic resection","authors":"Koichiro Haruki,&nbsp;Kenei Furukawa,&nbsp;Munetoshi Akaoka,&nbsp;Masashi Tsunematsu,&nbsp;Michinori Matsumoto,&nbsp;Tomohiko Taniai,&nbsp;Yoshihiro Shirai,&nbsp;Shinji Onda,&nbsp;Ryoga Hamura,&nbsp;Toru Ikegami","doi":"10.1002/ags3.12912","DOIUrl":"https://doi.org/10.1002/ags3.12912","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although osteopenia has been associated with poor outcomes in patients with hepatocellular carcinoma (HCC), the oncological impact of occult vertebral fracture (OVF) has not been investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study comprised 235 patients who had undergone primary hepatic resection for hepatocellular carcinoma between 2008 and 2019. Osteopenia was evaluated with computed tomographic measurement of pixel density in the midvertebral core of the 11th thoracic vertebra. OVF was defined if the ratios of central/anterior or central/posterior heights of the vertebrae, measured using sagittal computed tomography reconstruction between 11th thoracic vertebra to 5th lumber vertebrae, &lt;0.8. Multivariate Cox proportional hazard models were conducted to assess disease-free and overall survival adjusting for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Occult vertebral fracture was identified in 93 patients (40%), while osteopenia in 65 patients (28%). Osteopenic OVF was identified in 27 patients (12%). In multivariate analysis, gender (<i>p</i> &lt; 0.001), serum PIVKA-II level ≥ 200 mAU/ml (<i>p</i> = 0.005), C-reactive protein-to-albumin ratio ≥0.04 (<i>p</i> = 0.03), multiple tumors (<i>p</i> &lt; 0.001), type of resection (<i>p</i> &lt; 0.001), low skeletal muscle index (<i>p</i> = 0.002), and osteopenic OVF (HR 3.07, 95% CI 1.78–5.28, <i>p</i> &lt; 0.001) were independent and significant predictors of cancer recurrence, while gender (<i>p</i> = 0.002), Child–Pugh grade B (<i>p</i> = 0.009), C-reactive protein-to-albumin ratio ≥0.04 (<i>p</i> = 0.03), multiple tumors (<i>p</i> = 0.005), low skeletal muscle index (<i>p</i> &lt; 0.001), and osteopenic OVF (HR 4.75, 95% CI 2.41–9.39, <i>p</i> &lt; 0.001) were independent predictors of overall survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Osteopenic OVF is associated with poor oncological outcomes in patients with hepatocellular carcinoma after hepatic resection. Our findings provide a compelling rationale for the further investigation of the interplay between tumor and bone metabolism.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"804-813"},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12912","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520248","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 significance of preoperative Glasgow prognostic score in patients with colorectal cancer and synchronous peritoneal metastases","authors":"Kosuke Fujimoto,&nbsp;Fumikazu Koyama,&nbsp;Hirotoshi Kobayashi,&nbsp;Kenjiro Kotake,&nbsp;Masayasu Kawasaki,&nbsp;Yukihide Kanemitsu,&nbsp;Yusuke Kinugasa,&nbsp;Hideki Ueno,&nbsp;Kotaro Maeda,&nbsp;Takeshi Suto,&nbsp;Michio Itabashi,&nbsp;Kimihiko Funahashi,&nbsp;Heita Ozawa,&nbsp;Shingo Noura,&nbsp;Hideyuki Ishida,&nbsp;Masayuki Ohue,&nbsp;Tomomichi Kiyomatsu,&nbsp;Soichiro Ishihara,&nbsp;Keiji Koda,&nbsp;Hideo Baba,&nbsp;Kenji Kawada,&nbsp;Yojiro Hashiguchi,&nbsp;Takanori Goi,&nbsp;Yuji Toiyama,&nbsp;Naohiro Tomita,&nbsp;Eiji Sunami,&nbsp;Fumihiko Fujita,&nbsp;Jun Watanabe,&nbsp;Kenichi Hakamada,&nbsp;Goro Nakayama,&nbsp;Kenichi Sugihara,&nbsp;Yoichi Ajioka","doi":"10.1002/ags3.12918","DOIUrl":"https://doi.org/10.1002/ags3.12918","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chemotherapy is the typical choice for treating colorectal cancer with synchronous peritoneal metastases. Nonetheless, surgical resection may be chosen if the metastases are resectable. Unfortunately, there is no reliable preoperative or intraoperative prognostic indicator. This study aimed to determine the prognostic significance of the preoperative Glasgow prognostic score (GPS) in colorectal cancer patients with synchronous peritoneal metastases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a prospective study on 143 patients with colorectal cancer and concurrent peritoneal metastases. Our analysis included prognostic factors, such as the GPS, using data from the institutional observational study by the Japanese Society for Cancer of the Colon and Rectum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 3-year survival rates for the GPS0 or 1 and GPS2 groups were 32.7% and 14.3%, respectively, with a significantly worse prognosis in the GPS2 group (<i>p</i> = 0.003). Multivariate analysis identified GPS2 (<i>p</i> = 0.006) and the peritoneal cancer index (PCI) (<i>p</i> = 0.029) or the Japanese surgical peritoneal metastasis grade (<i>p</i> = 0.009) as independent poor prognostic factors. Additionally, the GPS0 or 1 group with total resection of peritoneal metastases had a significantly better prognosis than the non-resection group (<i>p</i> &lt; 0.001); however, there was no difference between the GPS2 group with total peritoneal resection and the non-resection group (<i>p</i> = 0.713).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Preoperative GPS2 is an independent poor prognostic factor in patients with colorectal cancer and synchronous peritoneal metastases, and surgical resection does not improve prognosis in patients with GPS2. Preoperative GPSs may be used as indicators for surgical resection of synchronous peritoneal metastases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"750-760"},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12918","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520245","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 primary tumor clinicopathological factors on prognosis after hepatic resection for rectal liver metastases","authors":"Tomofumi Uotani,&nbsp;Takeshi Takamoto,&nbsp;Satoshi Nara,&nbsp;Daisuke Ban,&nbsp;Takahiro Mizui,&nbsp;Konosuke Moritani,&nbsp;Shunsuke Tsukamoto,&nbsp;Yukihide Kanemitsu,&nbsp;Tsutomu Fujii,&nbsp;Minoru Esaki","doi":"10.1002/ags3.12917","DOIUrl":"https://doi.org/10.1002/ags3.12917","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Treatment of liver metastases from rectal cancer has been considered based on research data on liver metastases from colorectal cancer. This study aimed to clarify the impact of clinicopathological factors of the primary lesion, including rectal cancer-specific factors such as lateral lymph node metastasis, on the prognosis after liver resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a single-center retrospective study of patients undergoing curative surgical treatment for resectable liver metastases from rectal cancer from January 2010 to June 2023. Prognostic factors were investigated using univariable and multivariable analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort consisted of 113 males and 44 females, with a median age of 60 years. Lateral lymph node dissection was performed in 48 patients, of which 11 had positive nodes. Multivariable analysis revealed lateral lymph node metastasis (HR 5.86; 95% CI 2.40–14.2; <i>p</i> = 0.0001) and perineural invasion (HR 2.83; 95% CI 1.36–5.88; <i>p</i> = 0.005) as independent prognostic factors. After curative hepatectomy, 73.3% of patients with these two factors showed early recurrence within 6 months, requiring nonsurgical treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lateral lymph node metastasis and perineural invasion of the primary tumor were prognostic factors after resection of rectal liver metastases. Patients with these factors required nonsurgical treatment in the early postoperative period.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"814-821"},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12917","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520247","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 body mass index as a continuous variable on short- and long-term outcomes in patients undergoing laparoscopic surgery for colon cancer","authors":"Takayuki Aiba,&nbsp;Tomonori Akagi,&nbsp;Hidefumi Shiroshita,&nbsp;Kentaro Nakajima,&nbsp;Tetsuji Ohyama,&nbsp;Tatsuya Kinjo,&nbsp;Akiyoshi Kanazawa,&nbsp;Nobuaki Suzuki,&nbsp;Takuya Tokunaga,&nbsp;Manabu Yamamoto,&nbsp;Nobuki Ichikawa,&nbsp;Shungo Endo,&nbsp;Yutaka Kojima,&nbsp;Takatoshi Nakamura,&nbsp;Shuji Saito,&nbsp;Yoshinori Kagawa,&nbsp;Shinobu Ohnuma,&nbsp;Seiichiro Yamamoto,&nbsp;Takeshi Naitoh,&nbsp;Masafumi Inomata","doi":"10.1002/ags3.12916","DOIUrl":"https://doi.org/10.1002/ags3.12916","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The impact of obesity on colon cancer remains unclear. Very few studies of colon cancer surgery have analyzed body mass index (BMI) as a continuous variable, with no such reports from Japan. This study examined the association between BMI as a continuous variable and short- and long-term outcomes of laparoscopic surgery for obese colon cancer patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Obese (BMI ≥25 kg/m²) patients who underwent laparoscopic radical surgery for Stage II/III colon cancer at 46 participating centers from 2009 to 2013 were included. Associations between short- and long-term outcomes and BMI as a continuous variable were analyzed by univariate and multivariate regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among patients meeting the study criteria, 1036 were examined. BMI as a continuous variable correlated with log-transformed operative time (regression coefficient: 0.02, 95% confidence interval [CI]: 0.012–0.028, <i>p</i> &lt; 0.05) and blood loss (odds ratio: 1.089, 95% CI: 1.032–1.149, <i>p</i> &lt; 0.05). There was no association between BMI continuous variables and 3-year relapse-free survival (RFS) and overall survival. However, 3-year RFS was possibly better in patients with BMI ≥28.5 kg/m² versus those with BMI &lt;28.5 kg/m² (hazard ratio: 0.682, 95% CI: 0.462–1.008, <i>p</i> = 0.055).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study showed that BMI as a continuous variable correlated with operative time and blood loss. RFS was possibly better in the severely obese patients (BMI ≥28.5 kg/m²), suggesting that the prognosis for highly obese colon cancer patients appears to follow the obesity paradox.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"392-400"},"PeriodicalIF":2.9,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12916","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950528","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":"Short-term outcomes of intracorporeal anastomosis in laparoscopic colectomy for colon cancer: A nationwide, multi-institutional cohort study in Japan (ICAN study)","authors":"Tomohiro Yamaguchi,&nbsp;Keitaro Tanaka,&nbsp;Jun Watanabe,&nbsp;Hiroki Hamamoto,&nbsp;Atsushi Nishimura,&nbsp;Fumihiko Fujita,&nbsp;Hirokazu Suwa,&nbsp;Masaaki Ito,&nbsp;Kazushige Kawai,&nbsp;Junichiro Hiro,&nbsp;Seiichiro Yamamoto,&nbsp;Sho Nambara,&nbsp;Masato Ota,&nbsp;Yuri Ito,&nbsp;Junji Okuda,&nbsp;Masafumi Inomata,&nbsp;Masahiko Watanabe,&nbsp;Takeshi Naitoh,&nbsp;ICAN Collaborative Study Group of the Japan Society of Laparoscopic Colorectal Surgery","doi":"10.1002/ags3.12915","DOIUrl":"https://doi.org/10.1002/ags3.12915","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Several randomized controlled trials and meta-analyses have demonstrated the potential advantages of intracorporeal over extracorporeal anastomosis. However, the heterogeneity and small samples of these studies complicate drawing clear conclusions regarding such advantages. In this nationwide, multicenter, retrospective cohort study, we aimed to clarify the benefits of intracorporeal over extracorporeal anastomosis in patients undergoing laparoscopic colectomy for colon cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 46 institutions. Patients with clinical stage 0–III colon adenocarcinoma who underwent laparoscopic colectomy between January 2020 and December 2021 were evaluated. The effect of intracorporeal anastomosis on short-term outcomes compared to extracorporeal anastomosis was assessed using propensity score matching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1245 patients (intracorporeal, <i>n</i> = 615; extracorporeal, <i>n</i> = 630) were included in the final analysis. The operative time was longer (228 vs. 207 min, <i>p</i> &lt; 0.001), but blood loss was also lower (5.0 vs. 10.0 mL, <i>p</i> &lt; 0.001) and the incidence of intraoperative vascular injury appeared lower (0.5% vs. 1.6%, <i>p</i> = 0.091) in the intracorporeal group than those in the extracorporeal group. The time to first passage of stool (2.9 vs. 3.5 days, <i>p</i> &lt; 0.001) and length of hospital stay (9.3 vs. 10.2 days, <i>p</i> = 0.008) were shorter in the intracorporeal group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Intracorporeal anastomosis showed advantages over extracorporeal anastomosis in terms of blood loss, intraoperative vascular injury (potentially), bowel recovery, and length of hospital stay, despite the longer operative time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"739-749"},"PeriodicalIF":2.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12915","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520163","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}