Annals of Gastroenterological Surgery最新文献

{"title":"Novel body component score predicts long-term survival in patients with stage I–III colorectal cancer following radical resection","authors":"Takashi Aida,&nbsp;Teppei Kamada,&nbsp;Taigo Hata,&nbsp;Junji Takahashi,&nbsp;Eisaku Ito,&nbsp;Kenei Furukawa,&nbsp;Masashi Yoshida,&nbsp;Hironori Ohdaira,&nbsp;Toru Ikegami,&nbsp;Yutaka Suzuki","doi":"10.1002/ags3.12890","DOIUrl":"https://doi.org/10.1002/ags3.12890","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In gastrointestinal cancer, the relationship among skeletal muscle, subcutaneous and visceral fat mass, and prognosis is gaining attention. Herein, we developed a body component score (BCS) to comprehensively evaluate total body composition in patients with stage I–III colorectal cancer (CRC) and examined its relationship with long-term prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 300 patients with CRC who underwent curative colorectal resection in 2010–2019. The BCS included skeletal muscle index (SMI), subcutaneous fat area (SFA), visceral fat area (VFA), fatty liver, and pancreatic fatty replacement, measured by preoperative computed tomography. The BCS was calculated as the sum of each score from 0 to 5; patients were grouped into low (score 0–1), medium (score 2–3), and high (score 4–5) BCS. Multivariate Cox proportional hazard models assessed disease-free (DFS) and cancer-specific survival (CSS) in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Multivariate analysis showed that T3 or T4 tumors (<i>p</i> = 0.038), pathological stage III (<i>p</i> &lt; 0.001), and low BCS [<i>p</i> = 0.016; hazard ratio (HR), 1.95; 95% confidence interval (CI), 1.13–3.35] were independently associated with DFS, whereas pathological stage III (<i>p</i> &lt; 0.001) and low BCS (<i>p</i> = 0.001; HR, 3.14; 95% CI, 1.57–6.27) were independent prognostic factors for CSS. Patients with a low BCS had significantly worse DFS (<i>p</i> &lt; 0.001) and CSS (<i>p</i> &lt; 0.001), according to the log-rank test for trends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The BCS may effectively predict prognosis in patients with CRC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"529-537"},"PeriodicalIF":2.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950552","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":"Preoperative sarcopenia negatively impacts short- and long-term outcomes of rectal cancer: A propensity score-matched analysis","authors":"Shinya Abe,&nbsp;Hiroaki Nozawa,&nbsp;Kazuhito Sasaki,&nbsp;Koji Murono,&nbsp;Shigenobu Emoto,&nbsp;Kensuke Kaneko,&nbsp;Yuichiro Yokoyama,&nbsp;Hiroyuki Matsuzaki,&nbsp;Yuzo Nagai,&nbsp;Soichiro Ishihara","doi":"10.1002/ags3.12889","DOIUrl":"https://doi.org/10.1002/ags3.12889","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Sarcopenia is associated with poor postoperative outcomes in various cancers; however, limited evidence is available for rectal cancer. Therefore, the present study examined the effects of skeletal muscle mass on the short- and long-term outcomes of rectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A total of 787 Stage I–IV rectal cancer patients who underwent curative resection between 2003 and 2021 at The University of Tokyo Hospital were included. We conducted a propensity score-matched analysis to mitigate confounding bias. The third lumber psoas muscle mass was measured to define sarcopenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 787 patients, 350 (44.5%) were classified as having sarcopenia. After matching, 532 patients were analyzed. Patient characteristics in the sarcopenia and nonsarcopenia groups were similar; however, the body mass index differed. The sarcopenia group had significantly higher rates of postoperative complications of all grades (33.1% vs 24.8%; <i>p</i> = 0.035), of grade ≥2 (29.3% vs 21.8%; <i>p</i> = 0.047), and anastomotic leakage (1.9% vs 0%; <i>p</i> = 0.0082) than the nonsarcopenia group. The 5-y overall survival rate was significantly lower in the sarcopenia group than in the nonsarcopenia group (85.3% vs 91.8%, <i>p</i> = 0.019). Disease-free survival was similar between the groups (<i>p</i> = 0.40). In the total cohort analysis, sarcopenia was an independent risk factor for total postoperative complications (odds ratio 1.41, <i>p</i> = 0.042).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative sarcopenia is associated with more total postoperative complications, more anastomotic leakage, and worse survival in rectal cancer patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"518-528"},"PeriodicalIF":2.9,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interview with Prof. Dr. Jeffrey Drebin, President of the 2024 President Elect of the American Surgical Association","authors":"Koshi Mimori,&nbsp;Tsutomu Fujii,&nbsp;Masayuki Sho,&nbsp;Itaru Endo,&nbsp;Ken Shirabe,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12882","DOIUrl":"10.1002/ags3.12882","url":null,"abstract":"<p><b>Dr. Jeffrey A. Drebin</b> is Chair of the Department of Surgery at the Memorial Sloan Kettering Cancer Center and holds the Murray F. Brennan Endowed Chair. He is also Professor of Surgery at Weill Cornell Medical College. He was previously the John Rhea Barton Professor and Chair of the Department of Surgery at the Perelman School of Medicine of the University of Pennsylvania. He received his M.D. and Ph.D. degrees from Harvard, where his Ph.D. work involved the development of the first monoclonal antibodies targeting the HER2/neu oncogene. He subsequently performed his surgical training in General Surgery and a Fellowship in Surgical Oncology at the Johns Hopkins Hospital. Upon completing his clinical training, Dr. Drebin was recruited to Washington University School of Medicine in 1995, rising to Professor of Surgery and of Molecular Biology &amp; Pharmacology in 2002.</p><p>In 2004 he was recruited to the University of Pennsylvania as Chief of the GI Surgery Division and in 2009 he became department Chair. At Washington University and at the University of Pennsylvania he established himself as a busy clinical surgeon, focusing on pancreaticobiliary, upper gastrointestinal, and liver surgery. He also established a successful translational research lab, receiving research support from the NIH, the Department of Defense, and the Burroughs Welcome fund for this work. Multiple surgery residents who worked in Dr. Drebin's laboratory have themselves gone on to successful academic surgical careers. He has published over 150 peer-reviewed articles, chapters, editorials, and reviews, and has served on the editorial boards of multiple journals.</p><p>Today, we are honored to have Professor Jeff Drebin, M.D., Ph.D., from Memorial Sloan Kettering Cancer Center, and the 2024 President Elect of the American Surgical Association, as our guest. We extend our sincere gratitude to Professor Drebin for taking time out of his busy schedule to join us at the 79th Annual Meeting of The Japanese Society of Gastroenterological Surgery. In addition, we deeply appreciate your participation and your contribution to the journal, <i>Annals of Gastroenterological Surgery</i>, an official journal of JSGS. Thank you very much, Professor Jeff.</p><p>We're going to wrap up this conversation. Thank you very much for your insightful elaboration and explanation about pancreatic cancer. We face significant challenges in curing pancreatic cancer, but today's discussion with Professor Drebin provides a glimmer of hope. In the future, we may be able to eradicate pancreatic cancer. Thank you very much for your active discussion.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"24-31"},"PeriodicalIF":2.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three timepoint perioperative CEA levels are a prognostic factor for recurrence after adjuvant chemotherapy in patients with Stage II and III colorectal cancer","authors":"Shodai Mizuno,&nbsp;Kohei Shigeta,&nbsp;Ryosuke Hara,&nbsp;Kyoko Sakamoto,&nbsp;Jumpei Nakadai,&nbsp;Hideo Baba,&nbsp;Hiroto Kikuchi,&nbsp;Yoko Adachi,&nbsp;Takehiro Shimada,&nbsp;Hirofumi Suzumura,&nbsp;Kiyoaki Sugiura,&nbsp;Shimpei Matsui,&nbsp;Ryo Seishima,&nbsp;Koji Okabayashi,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12886","DOIUrl":"https://doi.org/10.1002/ags3.12886","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate the relationship between the three timepoint perioperative CEA (ttpCEA) calculated at three timepoints and recurrence during the perioperative period in Stage II and III colorectal cancer (CRC) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a multi-institutional retrospective analysis of patients with Stage II and III CRC who underwent surgery and adjuvant chemotherapy from 2010 to 2020. Patient data from three facilities were used as training data, and data from three other facilities were used as validation data. The primary endpoint was the time to recurrence (TTR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 538 patients were included for the training data. To validate the feasibility of ttpCEA, 329 patients were included for the validation data. Training data patients were categorized as ttpCEA low (<i>n</i> = 365) and ttpCEA high (<i>n</i> = 173). The 5-y TTR was significantly greater in the ttpCEA-low subgroup than in the ttpCEA-high subgroup (84.3% vs. 69.6%, respectively; <i>p</i> &lt; 0.001). Validation data patients were categorized as ttpCEA low (<i>n</i> = 221) and ttpCEA high (<i>n</i> = 108). The 5-y TTR was significantly greater in the ttpCEA-low subgroup than in the ttpCEA-high subgroup (82.9% vs. 68.7%, respectively; <i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The ttpCEA calculated from perioperative CEA levels at different timepoints was a prognostic factor for recurrence in Stage II and III CRC patients who underwent adjuvant chemotherapy according to both the training and validation data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"496-504"},"PeriodicalIF":2.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12886","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950230","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":"Liver resection in patients with a history of local ablation for hepatocellular carcinoma has the risk of poor survival and serosal invasion","authors":"Yusuke Nishi,&nbsp;Katsunori Sakamoto,&nbsp;Mio Uraoka,&nbsp;Tomoyuki Nagaoka,&nbsp;Masahiko Honjo,&nbsp;Kei Tamura,&nbsp;Naotake Funamizu,&nbsp;Kohei Ogawa,&nbsp;Yasutsugu Takada,&nbsp;Yuzo Umeda","doi":"10.1002/ags3.12872","DOIUrl":"https://doi.org/10.1002/ags3.12872","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim was to evaluate the impact of previous local ablation (LA) on long-term prognoses and tumor histopathological findings following hepatectomy for hepatocellular carcinoma (HCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study used data from patients who underwent initial hepatectomy for HCC at Ehime University Hospital between October 2003 and July 2021. Using data from a total of 234 patients, after excluding patients with distant metastasis or macroscopic residual tumors and patients with mixed HCC, a group of 39 patients who underwent post-ablation liver resection (PALR) was compared with a group of 195 non-PALR patients with respect to patient characteristics, perioperative data, pathological findings, and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Number of tumors was significantly greater and diameter of tumor was smaller in PALR group than those of non-PALR group. Both overall survival (OS) and recurrence-free survival (RFS) were significantly poor in PALR group than those of non-PALR (5-year OS 54.1% vs. 66.9%, <i>p</i> = 0.024; 5-year RFS 24.7% vs. 37.0%, <i>p</i> = 0.019). However, PALR was not selected as independent prognosticator in multivariate analyses. In PALR group, tumor size ≥3 cm was sole independent prognosticator in multivariate analyses. Multivariate analysis showed that PALR [odds ratio (OR), 8.989; 95% confidence interval (CI), 2.807–28.787], alpha-fetoprotein level &gt;40 ng/mL (OR, 2.923; 95% CI, 1.063–8.035), and des-γ-carboxyprothrombin level &gt;170 mAU/mL (OR, 5.164; 95% CI, 1.622–16.438) were independent predictors of pathological serosal invasion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Hepatectomy for patients with history of LA for HCC had a risk of serosal invasion and poor survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 2","pages":"347-358"},"PeriodicalIF":2.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12872","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of short-term outcomes and perioperative costs in laparoscopic versus robotic surgery for rectal cancers: A real-world cohort study using Japanese nationwide inpatient database","authors":"Hiroki Hamamoto,&nbsp;Masato Ota,&nbsp;Takafumi Shima,&nbsp;Toru Kuramoto,&nbsp;Kazuya Kitada,&nbsp;Kohei Taniguchi,&nbsp;Mitsuhiro Asakuma,&nbsp;Yasuhiro Oura,&nbsp;Yuri Ito,&nbsp;Sang-Woong Lee","doi":"10.1002/ags3.12884","DOIUrl":"10.1002/ags3.12884","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Many studies have revealed the benefits of robotic surgery for rectal cancer; however, real-world data are insufficient. This study aimed to compare the short-term outcomes and perioperative costs of laparoscopic and robotic surgery for rectal cancer using a real-world database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data of patients who underwent laparoscopic or robotic surgery for rectal cancer between January 2018 and January 2021 from a nationwide Japanese inpatient database provided by Medical Data Vision Co., Ltd. were analyzed. We performed propensity score matching (PSM) analysis to compare the in-hospital mortality, morbidity, readmission rate, reoperation rate, length of postoperative stay, and medical costs between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We performed PSM analysis on 18 952 eligible patients. After PSM, 1396 patients in the laparoscopic group and 1396 in the robotic group were compared. The robotic group had a lower surgical site infection rate (2.9% vs. 1.5%, <i>p</i> = 0.010), lower respiratory failure rate (1.3% vs. 0.6%, <i>p</i> = 0.049), and higher operative medical costs (1 291 371 vs. 1 312 462 JPY, <i>p</i> = 0.013). The total medical costs of the two groups were comparable (1 862 439 vs. 1 895 822 JPY, <i>p</i> = 0.051).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PSM analysis revealed that robotic surgery was associated with better outcomes than laparoscopic surgery in terms of surgical site infection and respiratory failure rates. The operative medical costs of robotic surgery were significantly higher than those of laparoscopic surgery. However, there was no significant difference in the total medical costs between robotic and laparoscopic surgery for rectal cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"4-11"},"PeriodicalIF":2.9,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possibly more favorable short-term outcomes with minimally invasive surgery than with open surgery in total gastrectomy for locally advanced gastric cancer: A single high-volume center study","authors":"Motonari Ri,&nbsp;Masaru Hayami,&nbsp;Manabu Ohashi,&nbsp;Rie Makuuchi,&nbsp;Tomoyuki Irino,&nbsp;Takeshi Sano,&nbsp;Souya Nunobe","doi":"10.1002/ags3.12881","DOIUrl":"https://doi.org/10.1002/ags3.12881","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Minimally invasive total gastrectomy (MTG) requires advanced surgical skills and is still associated with a higher rate of postoperative complications than other types of gastrectomy. Additionally, the short-term outcomes of MTG compared to open total gastrectomy (OTG) for locally advanced gastric cancer have yet to be demonstrated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively compared short-term outcomes between MTG and OTG for locally advanced gastric and esophago-gastric junctional cancer, performed at the Cancer Institute Hospital, Tokyo, during the period from January 2017 to March 2024. Propensity score matching (PSM) was conducted to adjust for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 359 patients were included, with 190 remaining after PSM, resulting in 95 in each group. The MTG group experienced a significantly lower incidence of postoperative complications of Clavien–Dindo classification (C-D) ≥3 than the OTG group (3.2% vs. 11.6%, <i>p</i> = 0.026). Moreover, the rate of postoperative intra-abdominal infectious complications (IAIC) was significantly lower in the MTG than in the OTG group (C-D ≥ 2; 7.4% vs. 17.9%, <i>p</i> = 0.029 and C-D ≥ 3; 2.1% vs. 9.5%, <i>p</i> = 0.030, respectively). Subgroup analyses showed the odds ratios for IAIC with C-D ≥ 2 to be more favorable for the MTG than the OTG group in male patients, those ≥70 years of age, patients without esophageal invasion, those without neoadjuvant chemotherapy, those diagnosed with cT≥3, and patients not undergoing combined resection of other organs except for the gallbladder or spleen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MTG for locally advanced gastric cancer may provide improved short-term outcomes compared to OTG, when performed or supervised by surgeons with high proficiency in laparoscopic techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"439-447"},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12881","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950079","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":"Association between surgical difficulty and tumor location based on subsegments of the Glisson branches in laparoscopic liver resection","authors":"Taisuke Imamura,&nbsp;Yusuke Yamamoto,&nbsp;Ryo Morimura,&nbsp;Hisashi Ikoma,&nbsp;Tomohiro Arita,&nbsp;Hirotaka Konishi,&nbsp;Atsushi Shiozaki,&nbsp;Takeshi Kubota,&nbsp;Hitoshi Fujiwara,&nbsp;Eigo Otsuji","doi":"10.1002/ags3.12879","DOIUrl":"https://doi.org/10.1002/ags3.12879","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Laparoscopic liver resection has a steep learning curve, and multiple difficulty-scoring systems have been proposed to support safe implementation. Though the IWATE scoring system is widely used, the rationale for its tumor location score is unclear. The objective of our study was to establish a more accurate definition of tumor location based on subsegments of the Glisson branches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 176 patients who underwent laparoscopic liver resection between January 2017 and February 2024, excluding those who underwent multiple or concomitant resections of other organs. Tumor location was defined by the most proximal subsegment of the Glisson branches (1sp, Spiegel; 1pc, para-caval; 1cp, caudate process; 3a, apical; 3b, basal; 4a; 4b; 5v, ventral; 5d, dorsal; 6v; 6d; 6 L, lateral; 7v; 7d; 8v; 8d).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Within each segment, comparing operative time between subsegments showed significant differences, except for S1 (3a vs. 3b, <i>p</i> = 0.011; 4a vs. 4b, <i>p</i> = 0.001; 5v vs. 5d, <i>p</i> = 0.012; 6v vs. 6d vs. 6 L, <i>p</i> = 0.007; 7v vs. 7d, <i>p</i> = 0.003; 8v vs. 8d, <i>p</i> = 0.030). Blood loss significantly differed except for S1 (3a vs. 3b, <i>p</i> = 0.018; 4a vs. 4b, <i>p</i> = 0.002; 5v vs. 5d, <i>p</i> = 0.016; 6v vs. 6d vs. 6 L, <i>p</i> = 0.011; 7v vs. 7d, <i>p</i> = 0.013; 8v vs. 8d, <i>p</i> &lt; 0.001). The incidence of postoperative complications did not differ significantly; however, hospital stay was significantly different only in S4 (4a vs. 4b, <i>p</i> = 0.049).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There are significant differences in the difficulty of laparoscopic liver resection among subsegments. More detailed scoring based on subsegments may improve accuracy, and we propose a new scoring system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"546-558"},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12879","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950080","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":"Prognostic value of surgical treatment in elderly patients with ulcerative colitis-associated colorectal cancer: A subanalysis of a nationwide Japanese multicenter study","authors":"Kinuko Nagayoshi,&nbsp;Yusuke Mizuuchi,&nbsp;Masafumi Nakamura,&nbsp;Koji Okabayashi,&nbsp;Motoi Uchino,&nbsp;Hiroki Ikeuchi,&nbsp;Tatsuki Noguchi,&nbsp;Soichiro Ishihara,&nbsp;Yoichi Ajioka,&nbsp;Kenichi Sugihara,&nbsp;from the Study Group for Inflammatory Bowel Disease Associated Intestinal Cancers by the Japanese Society for Cancer of the Colon and Rectum","doi":"10.1002/ags3.12885","DOIUrl":"https://doi.org/10.1002/ags3.12885","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Our study aimed to examine the characteristics of elderly patients diagnosed with ulcerative colitis-associated colorectal cancer (UAC) and evaluate the impact of surgical intervention on prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 1086 patients diagnosed with UAC between 1980 and 2020 were retrospectively enrolled. Data were collected through the Japanese Society for Cancer of the Colon and Rectum project. The patients were divided into two groups: 248 elderly patients in the E-UAC group and 838 nonelderly patients in the NE-UAC group. Patients aged &gt;65 y at cancer diagnosis were considered elderly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The recurrence rate did not differ between the two groups. Segmental resection was the only common independent risk factor for recurrence in both the E-UAC and the NE-UAC groups. The E-UAC patients had significantly better 5-y disease-specific survival (DSS) than the NE-UAC patients (94.7% vs 91.0%, <i>p</i> = 0.04). There were no differences in 5-y recurrence-free survival (RFS; 89.3% vs 86.6%, respectively, <i>p</i> = 0.24) or overall survival (OS; 88.8% vs 89.6%, <i>p</i> = 0.50). The E-UAC patients who underwent segmental resection had poorer RFS than those who underwent total proctocolectomy, but there were no significant differences in DSS or OS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite the elevated risk of cancer recurrence observed in the UAC patients who underwent segmental resection in both the E-UAC the NE-UAC groups, our findings suggested that segmental resection may be a viable alternative to total proctocolectomy in terms of survival rate for the E-UAC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"486-495"},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12885","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950141","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":"Identification of risk factors for postoperative complications after right colectomy and low anterior resection in patients ≥85 years old with colorectal cancer using the National Clinical Database","authors":"Tomonori Akagi,&nbsp;Shiori Nishimura,&nbsp;Yoshitake Ueda,&nbsp;Masafumi Inomata,&nbsp;Hidefumi Shiroshita,&nbsp;Shuji Takiguchi,&nbsp;Yoshiharu Sakai,&nbsp;Hiraku Kumamaru,&nbsp;Hideki Ueno,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12876","DOIUrl":"https://doi.org/10.1002/ags3.12876","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The purpose of this study was to evaluate factors associated with surgical outcomes and postoperative complications (Grade ≥3 by Clavien–Dindo classification) of right hemicolectomy (RH) and low anterior resection (LAR) for colorectal cancer in patients ≥85 years old.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed National Clinical Database (NCD) data on patients aged ≥85 years who underwent RH and LAR for colorectal cancer between 2017 and 2020. All possible preoperative factors were used to explore the risk factors for serious postoperative complication in these very elderly patients with colorectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For RH, the operative mortality rate was 1.1% (98 cases), and the rate of serious postoperative complications was 5.2% (480 cases). Similarly, the mortality rate was 1.1% (27 cases), and the rate of serious complications (Clavien–Dindo Grade ≥3) was 8.7% (206 cases) for LAR. Based on multivariate analysis, independent risk factors for serious postoperative complications were male sex, ADL (partially dependent), hypertension, platelets (&lt;150 000/μL), serum Na (&lt;138 mEq/L), and PT-INR (&gt;1.1) for RH, and ASA-PS (Grade ≥3), history of pneumonia, creatinine (&gt;1.2 mg/day), and serum Na (&lt;138 mEq/L) for LAR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present results for RH and LAR suggest that surgical treatment for patients aged ≥85 years old is safe and feasible. Surgeons need to pay special attention more to physical status and past medical history than to tumor factors to prevent serious postoperative complications in these older patients with colorectal cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 2","pages":"329-338"},"PeriodicalIF":2.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12876","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535964","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}