Annals of Gastroenterological Surgery最新文献

{"title":"The steatosis-associated fibrosis estimator score is a useful indicator of recurrence and survival after initial curative hepatectomy for hepatocellular carcinoma","authors":"Tomoaki Bekki,&nbsp;Masahiro Ohira,&nbsp;Yuki Imaoka,&nbsp;Minoru Hattori,&nbsp;Ryosuke Nakano,&nbsp;Hiroshi Sakai,&nbsp;Shintaro Kuroda,&nbsp;Hiroyuki Tahara,&nbsp;Kentaro Ide,&nbsp;Tsuyoshi Kobayashi,&nbsp;Hideki Ohdan","doi":"10.1002/ags3.12846","DOIUrl":"10.1002/ags3.12846","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Liver fibrosis predisposes patients to liver failure and hepatocellular carcinoma. Various markers, which can be calculated easily from serum parameters, have been reported to predict liver fibrosis accurately. This study investigated the prognostic factors, including blood-based markers for liver fibrosis of patients with hepatocellular carcinoma following initial curative hepatectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 407 patients with hepatocellular carcinoma who underwent initial curative hepatectomy between April 2010 and December 2017. We investigated prognosis-associated variables in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the blood-based markers for liver fibrosis examined in this study, the steatosis-associated fibrosis estimator score demonstrated the best predictive capabilities. This score was revealed as a poor prognostic factor for both overall survival and recurrence-free survival in patients with hepatocellular carcinoma following initial curative hepatectomy. A high steatosis-associated fibrosis estimator score was independently associated with poor overall survival and recurrence-free survival. After propensity score-matching to minimize bias between high- and low-steatosis-associated fibrosis estimator score groups, the high steatosis-associated fibrosis estimator score remained associated with poor overall survival and recurrence-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The steatosis-associated fibrosis estimator score is an independent predictor of long-term prognosis in patients with hepatocellular carcinoma following initial curative hepatectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"178-187"},"PeriodicalIF":2.9,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12846","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141812931","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":"Minimally invasive surgery versus open gastrectomy for older patients with gastric cancer: A propensity score-matching analysis","authors":"Masaaki Yamamoto,&nbsp;Takeshi Omori,&nbsp;Yasunori Masuike,&nbsp;Naoki Shinno,&nbsp;Hisashi Hara,&nbsp;Takahito Sugase,&nbsp;Takashi Kanemura,&nbsp;Atsushi Takeno,&nbsp;Motohiro Hirao,&nbsp;Hiroshi Miyata","doi":"10.1002/ags3.12842","DOIUrl":"10.1002/ags3.12842","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare minimally invasive and open surgery for older patients with gastric cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 464 consecutive patients with gastric cancer aged ≥75 years who underwent open or laparoscopic gastrectomy at our institution from January 2004 to December 2018. We performed propensity score-matching and compared short- and long-term outcomes between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After matching, 332 patients were included in the study (166 in each group). The laparoscopy group had a longer operative time, lesser blood loss, and shorter hospital stays than the open surgery group (all <i>p</i> &lt; 0.020). The laparoscopy group had a lower complication rate than the open surgery group (<i>p</i> = 0.002). No significant differences were noted in the 3-y overall, recurrence-free, and disease-free survival between the groups (all <i>p</i> &gt; 0.200).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Minimally invasive surgery for older patients with gastric cancer may be more beneficial than open gastrectomy in terms of blood loss and hospital stay.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"69-78"},"PeriodicalIF":2.9,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12842","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141647789","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":"Transanal minimally invasive proctectomy for ulcerative colitis is beneficial in terms of short-term outcomes and defecation function","authors":"Marie Hanaoka,&nbsp;Yusuke Kinugasa,&nbsp;Kenta Yao,&nbsp;Ayumi Takaoka,&nbsp;Megumi Sasaki,&nbsp;Shinichi Yamauchi,&nbsp;Masanori Tokunaga","doi":"10.1002/ags3.12844","DOIUrl":"10.1002/ags3.12844","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Despite being reported safety, the advantages of transanal minimally invasive proctocolectomy (TAMIP) are controversial, and comparative studies on postoperative defecation function between ileal pouch-anal anastomosis (IPAA) using laparoscopic transanal manipulation (TAMIP-IPAA) and without this technique (traditional IPAA) are lacking. This study analyzed TAMIP's impact on short-term and postoperative defecation function in patients with ulcerative colitis (UC) to evaluate its safety and feasibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Inclusion criteria comprised patients with UC undergoing minimally invasive proctocolectomy at our hospital from May 2014 to May 2023. The TAMIP-IPAA approach involved precise rectal mucosa removal while preserving the sphincter muscle during laparoscopic transanal manipulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the evaluation of short-term outcomes for 71 patients undergoing proctocolectomy, the TAMIP group (37 patients) outperformed the non-TAMIP group in operative time (395 vs. 289 min, <i>p</i> &lt; 0.001) and postoperative hospital stay (12 vs. 8 days, <i>p</i> &lt; 0.001). Additionally, TAMIP-IPAA demonstrated advantages over traditional IPAA (seven patients), in operative time (443 vs. 289 min, <i>p</i> = 0.006), intraoperative blood loss (392 vs. 130 mL, <i>p</i> = 0.001), postoperative hospital stay (18 vs. 8 days, <i>p</i> = 0.003), anastomotic leakage (42.9% vs. 8.1%, <i>p</i> = 0.041), and re-admission within 30 days (57.1% vs. 8.1%, <i>p</i> = 0.009). Wexner scores were significantly superior in the TAMIP-IPAA group at 6 months (14.5 vs. 8.0 points, <i>p</i> = 0.029) and 1 year post stoma closure (14.0 vs. 7.0 points, <i>p</i> = 0.020), indicating enhanced short-term outcomes and defecation function compared to traditional IPAA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TAMIP-IPAA for UC has the potential to offer promising benefits, including the enhancement of short-term outcomes and the improvement of defecation function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 6","pages":"1056-1066"},"PeriodicalIF":2.9,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12844","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141650025","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 factors for serious postoperative complications following gastrectomy in super-elderly patients ≥85-years-old with gastric cancer: A National Clinical Database study in Japan","authors":"Yoshitake Ueda,&nbsp;Shiori Nishimura,&nbsp;Masafumi Inomata,&nbsp;Tomonori Akagi,&nbsp;Hidefumi Shiroshita,&nbsp;Tsuyoshi Etoh,&nbsp;Shuji Takiguchi,&nbsp;Yoshiharu Sakai,&nbsp;Hiraku Kumamaru,&nbsp;Hideki Ueno,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12843","DOIUrl":"10.1002/ags3.12843","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to evaluate the technical safety and feasibility of gastrectomy for super-elderly patients ≥85-y-old with gastric cancer and to clarify the risk factors for serious postoperative complications in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between 2017 and 2020, 10,203 patients who underwent distal gastrectomy (DG) and 2580 patients who underwent total gastrectomy (TG) were reviewed from the Japanese National Clinical Database. All possible preoperative factors were used to explore the risk factors for serious postoperative complications in the super-elderly patients with gastric cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For DG, the operative mortality rate was 1.6% (162 patients), and the rate of serious postoperative complications was 7.8% (796 patients). Similarly, the mortality rate was 2.6% (67 patients), and the rate of serious complications was 11.3% (292 patients) for TG. Based on multivariate analysis, body mass index (≥25 kg/m²), activities of daily living (ADL) (partially dependent), ASA-PS (Grade ≥3), dyspnea, ascites, history of cerebrovascular disease, serum albumin (&lt;4 g/dL), and creatinine (&gt;1.2 mg/dL) in DG, and ADL (partially dependent), ASA-PS (Grade ≥3), previous percutaneous coronary intervention, dialysis, WBC (&gt;9000 μL), and AST (&gt;35 IU/L) in TG were strong risk factors for serious postoperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study findings suggest that gastrectomy for super-elderly gastric cancer patients is relatively safe and feasible. Surgeons need to pay special attention to physical status and past medical history than tumor factors for preventing serious postoperative complications in super-elderly gastric cancer patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"79-88"},"PeriodicalIF":2.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12843","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141659668","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 Endoscopic Surgical Skill Qualification System-certified surgeons as operators in laparoscopic rectal cancer surgery in Japan: A propensity score-matched analysis (subanalysis of the EnSSURE study)","authors":"Ken Kojo,&nbsp;Takahiro Yamanashi,&nbsp;Shigenori Homma,&nbsp;Manabu Yamamoto,&nbsp;Takuya Miura,&nbsp;Yoshiyuki Ishii,&nbsp;Atsushi Ishibe,&nbsp;Hiroomi Ogawa,&nbsp;Nobuki Ichikawa,&nbsp;Hiroaki Iijima,&nbsp;Masafumi Inomata,&nbsp;Akinobu Taketomi,&nbsp;Takeshi Naitoh,&nbsp;EnSSURE study group collaboratives in Japan Society of Laparoscopic Colorectal Surgery","doi":"10.1002/ags3.12841","DOIUrl":"10.1002/ags3.12841","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In Japan, the Endoscopic Surgical Skill Qualification System (ESSQS) is used to evaluate surgical skills essential for laparoscopic surgery, but whether surgeons with this certification as operators improve the short-term outcomes and prognosis after rectal cancer surgery is unclear. This cohort study was designed to compare the short-term and long-term outcomes of laparoscopic surgery for advanced rectal cancer performed by an ESSQS-certified surgeon versus a surgeon without ESSQS certification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The outcomes of cStage II and III rectal cancer surgery cases performed at 56 Japanese hospitals between 2014 and 2016 were retrospectively reviewed. To examine the impact of ESSQS-certified surgeons as surgeons, the outcomes of cases with only ESSQS-certified surgeons as operators were compared with those without involvement of ESSQS-certified surgeons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3197 cases were enrolled, with 1015 in which surgery was performed by ESSQS-certified surgeons, and 544 in which there was no involvement of ESSQS-certified surgeons. After propensity score matching, the ESSQS group had significantly shorter operative time (<i>p</i> &lt; 0.001), a lower conversion rate to open surgery (<i>p</i> &lt; 0.001), and more dissected lymph nodes (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Laparoscopic rectal surgery performed by ESSQS-certified surgeons was significantly associated with improved short-term outcomes. This demonstrates the utility of the ESSQS certification system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 6","pages":"1046-1055"},"PeriodicalIF":2.9,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12841","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141663102","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":"Feasibility and predictive factors on the completion of docetaxel plus S-1 adjuvant chemotherapy in pathological stage III gastric cancer","authors":"Masayoshi Terayama,&nbsp;Manabu Ohashi,&nbsp;Kensei Yamaguchi,&nbsp;Daisuke Takahari,&nbsp;Rie Makuuchi,&nbsp;Masaru Hayami,&nbsp;Satoshi Ida,&nbsp;Koshi Kumagai,&nbsp;Takeshi Sano,&nbsp;Souya Nunobe","doi":"10.1002/ags3.12840","DOIUrl":"10.1002/ags3.12840","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The standard adjuvant chemotherapy regimen for stage III gastric cancer is docetaxel plus S-1 (DS) based on the results of the START-II trials. However, in clinical practice some patients could not continue this intensive doublet chemotherapy because of limited tolerability. This study aimed to assess the practical feasibility of DS and elucidate the predictive factors for the completion of adjuvant DS therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from consecutive patients who underwent radical gastrectomy between 2018 and 2021 and were diagnosed with histopathologically confirmed stage III gastric cancer were retrospectively collected. First, the completion rate and adverse effects of DS were assessed. Second, the association between DS incompletion and patient backgrounds including body weight, skeletal muscle index (SMI), and intramuscular adipose content (IMAC) were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 87 patients, 59 patients (67.8%) completed DS and dose reduction was required in 18 patients (20.6%). Neutropenia of grade 3 or higher was the most common hematological toxicity observed (17.2%). The most frequent nonhematological toxicity of grade 3 or higher was fatigue (6.9%), followed by diarrhea (5.7%), nausea (4.5%), and anorexia (4.5%). In a multivariate analysis, low SMI (<i>p</i> = 0.005) and high IMAC (<i>p</i> = 0.004) were significant risk factors for DS incompletion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DS adjuvant chemotherapy after radical gastrectomy for pathological stage III gastric cancer is acceptable, even in clinical practice, with respect to completion and toxicity. Additionally, the body composition factors such as SMI and IMAC might be useful in predicting incompletion of DS. These findings will help us to preoperatively select patients for DS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"60-68"},"PeriodicalIF":2.9,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12840","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683389","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 geniohyoid muscle mass in esophageal cancer patients is associated with swallowing function after esophagectomy","authors":"Sanshiro Kawata,&nbsp;Yoshihiro Hiramatsu,&nbsp;Junko Honke,&nbsp;Tomohiro Murakami,&nbsp;Eisuke Booka,&nbsp;Tomohiro Matsumoto,&nbsp;Yoshifumi Morita,&nbsp;Hirotoshi Kikuchi,&nbsp;Katsuya Yamauchi,&nbsp;Hiroya Takeuchi","doi":"10.1002/ags3.12839","DOIUrl":"10.1002/ags3.12839","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Dysphagia often develops after esophagectomy. The geniohyoid muscle is involved in swallowing movements, but its significance in esophagectomy patients remains unclear. We investigated the relationship of preoperative geniohyoid muscle mass with post-esophagectomy swallowing function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method<b>s</b></h3>\u0000 \u0000 <p>We retrospectively analyzed 114 patients who underwent esophagectomy and gastric conduit reconstruction for esophageal malignancy. We evaluated preoperative geniohyoid muscle sagittal cross-sectional areas (cm²) using computed tomography. Median values for each sex were considered as cutoff values. Dysphagia severity was assessed using the Penetration–Aspiration Scale (PAS) during video-fluoroscopic swallowing studies performed 7–10 days postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cross-sectional area was significantly larger in males than in females (3.2 ± 0.7 vs. 2.4 ± 0.5, <i>p</i> &lt; 0.01: median in males: 3.2 cm², and in females: 2.3 cm²). These values were used to define high and low cross-sectional area groups. The cross-sectional area correlated positively with grip strength (correlation coefficient (CC) = 0.530) and skeletal muscle index (CC = 0.541). Transthyretin levels (22.4 ± 6.8 vs. 25.4 ± 5.5, <i>p</i> = 0.03) and cross-sectional area (2.6 ± 0.7 vs. 3.2 ± 0.8, <i>p</i> &lt; 0.01) were significantly lower in patients with (PAS score ≥6; 20%) than in those without aspiration during fluoroscopic swallowing studies. Recurrent laryngeal nerve palsy was significantly more frequent in those with than in those without aspiration during fluoroscopic studies (22% vs. 5%, <i>p</i> = 0.03). In the multivariate analysis, low cross-sectional area and recurrent laryngeal nerve palsy were both independent risk factors for aspiration during swallowing studies (odds ratio = 3.6, <i>p</i> = 0.03 and odds ratio = 6.6, <i>p</i> = 0.02, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative geniohyoid muscle mass, evaluated using neck computed tomography, can predict dysphagia after esophagectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 6","pages":"1026-1035"},"PeriodicalIF":2.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581096","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":"Effect of abdominal aortic calcification on long-term outcomes after the first liver resection in very old patients with hepatocellular carcinoma","authors":"Yosuke Namba,&nbsp;Masahiro Ohira,&nbsp;Yuki Imaoka,&nbsp;Michinori Hamaoka,&nbsp;Masakazu Hashimoto,&nbsp;Takashi Onoe,&nbsp;Daisuke Takei,&nbsp;Koichi Oishi,&nbsp;Megumi Yamaguchi,&nbsp;Tomoyuki Abe,&nbsp;Takeshi Tadokoro,&nbsp;Sotaro Fukuhara,&nbsp;Ko Oshita,&nbsp;Keiso Matsubara,&nbsp;Naruhiko Honmyo,&nbsp;Shintaro Kuroda,&nbsp;Hiroyuki Tahara,&nbsp;Tsuyoshi Kobayashi,&nbsp;Kentaro Ide,&nbsp;Hideki Ohdan","doi":"10.1002/ags3.12838","DOIUrl":"10.1002/ags3.12838","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We previously reported that abdominal aortic calcification is associated with poor overall and recurrence-free survival after hepatectomy for hepatocellular carcinoma (HCC). However, the effect of abdominal aortic calcification on cancer-specific prognosis in very old patients with several comorbidities remains unknown. This multicenter study aimed to evaluate the impact of abdominal aortic calcification on the cumulative recurrence rate and recurrence-free survival in patients with HCC aged &gt;80 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed the data of 128 patients (aged ≥80 years) who underwent liver resection for hepatocellular carcinoma at seven hospitals belonging to Hiroshima Surgical Study Group of Clinical Oncology between January 2014 and December 2018. Patients were divided into two groups: high and low abdominal aortic calcification groups. The primary endpoints were cumulative recurrence rate and recurrence-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Kaplan–Meier survival curve analysis demonstrated that the cumulative recurrence rate in the high abdominal aortic calcification group was significantly higher than that in the low abdominal aortic calcification group, and the high abdominal aortic calcification group had a significantly lower recurrence-free survival rate. In the multivariate analysis, high abdominal aortic calcification (<i>p</i> = 0.03), high des-gamma-carboxyprothrombin score (<i>p</i> = 0.04), and multiple tumors (<i>p</i> &lt; 0.01) were independent predictive factors for recurrent HCC, and high abdominal aortic calcification (<i>p</i> = 0.01) and high des-gamma-carboxyprothrombin (<i>p</i> = 0.01) were independent predictive factors for poor cancer-specific survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results indicate that the abdominal aortic calcification score is associated with cumulative recurrence rate and recurrence-free survival in very old patients with HCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"169-177"},"PeriodicalIF":2.9,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Essential updates 2022/2023: A review of current topics in robotic hepatectomy","authors":"Tomohiko Adachi,&nbsp;Takanobu Hara,&nbsp;Hajime Matsushima,&nbsp;Akihiko Soyama,&nbsp;Susumu Eguchi","doi":"10.1002/ags3.12817","DOIUrl":"10.1002/ags3.12817","url":null,"abstract":"<p>The liver requires careful handling intra-operatively owing to its vital functions and complexity. Traditional open hepatectomy, while standard, is invasive and requires long recovery periods. Laparoscopic hepatectomy is a less invasive option, with its own challenges. The rise of robotic surgery, such as the da Vinci® system, improves precision and control, addressing the limitations of conventional methods, but brings new concerns, such as costs and training. This review focuses on the latest advancements in robotic hepatectomy from 2022/23 articles, delving into topics like “robotic surgery in liver transplantation,” “robotic hepatectomy for hilar cholangiocarcinoma,” “robotic vascular reconstruction following hepatectomy,” “robotic repeat hepatectomy,” and “prospective trials in robotic hepatectomy.” To retrieve articles, a focused literature search was conducted using PubMed for articles from 2022/23 with a 5-year filter, excluding reviews. Initially, abstracts were screened, and relevant articles on robotic surgery were examined in full for inclusion in this review. Although all the above items are cutting-edge, and many of the references are necessarily at the level of case reports, recent articles are still accompanied by surgical videos, which are useful to readers, especially surgeons who are considering imitating the procedures. In summary, we examined the recent advancements in robotic liver resection. The inclusion of videos that present new techniques aids in knowledge transfer. We anticipate the continued growth of this field of research.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 5","pages":"774-777"},"PeriodicalIF":2.9,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124624","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":"Modified oral antibiotics and mechanical bowel preparation (OAMBP) versus conventional OAMBP for sigmoid colon and rectal surgery: A multicenter randomized non-inferiority trial","authors":"Sodai Arai,&nbsp;Marie Hanaoka,&nbsp;Shinichi Yamauchi,&nbsp;Hironobu Baba,&nbsp;Ryoichi Hanazawa,&nbsp;Hiroyuki Sato,&nbsp;Akihiro Hirakawa,&nbsp;Masanori Tokunaga,&nbsp;Yusuke Kinugasa","doi":"10.1002/ags3.12837","DOIUrl":"10.1002/ags3.12837","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate whether the use of a laxative with reduced patient burden in oral antibiotics and mechanical bowel preparation (OAMBP) could prevent surgical site infection (SSI) in left-sided colon and rectal cancers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter, non-blinded, randomized, non-inferiority trial included patients who underwent elective colorectal surgery for colorectal cancer in a university and community hospital in Japan from April 1, 2021 to March 31, 2023. We compared conventional OAMBP (polyethylene glycol, metronidazole, and kanamycin) (cOAMBP group) with modified OAMBP (sodium picosulfate hydrate, metronidazole, and kanamycin) (mOAMBP group). The primary outcome was overall incidence of SSI. Secondary outcomes were postoperative complications, degree of patient burden, and intraoperative bowel dilatation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 119 patients, 112 were randomly assigned to the two groups, with 56 patients in each group. SSI occurred in three (5.4%) and five patients (8.3%) in the mOAMBP and cOAMBP groups, respectively (90% confidence interval [CI]: −12.8–5.3), with a 15% margin of non-inferiority. Anastomotic leakage occurred in no patient in the mOAMBP group and three patients (5.4%) in the cOAMBP group (<i>p</i> = 0.24). The cOAMBP group reported significantly more pain than the mOAMBP group (50 [90.9%] vs. 7 [12.5%] participants). The mOAMBP group showed significantly lesser bowel dilatation than the cOAMBP group (1 [1.8%] vs. 21 [37.5%] participants).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>mOAMBP is safe and less burdensome, can reduce intraoperative bowel dilatation, and is non-inferior compared with cOAMBP in preventing SSI. Therefore, mOAMBP may be more suitable for sigmoid colon and rectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>UMIN000043162 (http://www.umin.ac.jp/ctr/). Registered on January 28, 2021.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 6","pages":"1036-1045"},"PeriodicalIF":2.9,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581071","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}