Annals of Gastroenterological Surgery最新文献

{"title":"Acknowledgments","authors":"","doi":"10.1002/ags3.12899","DOIUrl":"10.1002/ags3.12899","url":null,"abstract":"<p>The publication of invaluable papers in <i>Annals of Gastroenterological Surgery</i> depends on the prompt, careful review of submitted manuscripts. We would like to thank the following experts for reviewing manuscripts submitted between December 1, 2023 and November 30, 2024.</p><p>Reviewer Full Name</p><p>Abe, Tatsuya</p><p>Abe, Yuta</p><p>Aizawa, Masaki</p><p>Ajiki, Tetsuo</p><p>Akahoshi, Keiichi</p><p>Akamatsu, Nobuhisa</p><p>Akita, Hirofumi</p><p>Akiyoshi, Takashi</p><p>Aoki, Takeshi</p><p>Aoki, Taku</p><p>Aoyama, Toru</p><p>Araki, Kenichiro</p><p>Arigami, Takaaki</p><p>Arita, Junichi</p><p>Baba, Kenji</p><p>Ban, Daisuke</p><p>Bekki, Yuki</p><p>Booka, Eisuke</p><p>Daiko, Hiroyuki</p><p>Ebata, Tomoki</p><p>Ebihara, Yuma</p><p>Eguchi, Hidetoshi</p><p>Etoh, Tsuyoshi</p><p>Fujimura, Takashi</p><p>Fujita, Fumihiko</p><p>Fujita, Takeo</p><p>Fukagawa, Takeo</p><p>Fukami, Yasuyuki</p><p>Fukushima, Ryoji</p><p>Ganeko, Riki</p><p>Hagi, Takaomi</p><p>Hamabe, Atsushi</p><p>Hanaoka, Marie</p><p>Harada, Kazuto</p><p>Harimoto, Norifumi</p><p>Haruki, Koichiro</p><p>Hasegawa, Kiyoshi</p><p>Hasegawa, Yasushi</p><p>Hashimoto, Daisuke</p><p>Hashimoto, Masashi</p><p>Hatano, Etsuro</p><p>Hayami, Shinya</p><p>Hayashi, Hiromitsu</p><p>Hibi, Taizo</p><p>Hida, Koya</p><p>Hidaka, Masaaki</p><p>Hijioka, Susumu</p><p>Hirano, Satoshi</p><p>Hirano, Yasumitsu</p><p>Hirashita, Teijiro</p><p>Hiyoshi, Yukiharu</p><p>Honda, Goro</p><p>Hosoda, Kei</p><p>Ichikawa, Nobuki</p><p>Iguchi, Tomohiro</p><p>Ikeda, Masataka</p><p>Ikeda, Satoshi</p><p>Ikeuchi, Hiroki</p><p>Ikoma, Hisashi</p><p>Imamura, Yu</p><p>Inaki, Noriyuki</p><p>Inoue, Mikihiro</p><p>Iseda, Norifumi</p><p>Ishido, Keinosuke</p><p>Ishihara, Soichiro</p><p>Ishizawa, Takeaki</p><p>Ishizuka, Mitsuru</p><p>Itatani, Yoshiro</p><p>Ito, Takashi</p><p>Itoh, Shinji</p><p>Iwatsuki, Masaaki</p><p>Jiang, Xingming</p><p>Kagawa, Hiroyasu</p><p>Kagawa, Yoshinori</p><p>Kaibori, Masaki</p><p>Kaido, Toshimi</p><p>Kajiwara, Yoshiki</p><p>Kanda, Mitsuro</p><p>Kanemitsu, Yukihide</p><p>Kasai, Shunsuke</p><p>Kato, Atsushi</p><p>Kato, Motohiko</p><p>Kato, Yutaro</p><p>Kawachi, Shigeyuki</p><p>Kawada, Kenji</p><p>Kawai, Kazushige</p><p>Kawai, Manabu</p><p>Kawamura, Junichiro</p><p>Kawazoe, Tetsuro</p><p>Kim, Dong-Sik</p><p>Kimura, Yasutoshi</p><p>Kimura, Yutaka</p><p>Kinami, Shinichi</p><p>Kinoshita, Takahiro</p><p>Kitagawa, Akihiro</p><p>Kitago, Minoru</p><p>Kitai, Toshiyuki</p><p>Kitayama, Joji</p><p>Kiyomatsu, Tomomichi</p><p>Kobayashi, Hirotoshi</p><p>Kobayashi, Minako</p><p>Kobayashi, Shogo</p><p>Kobayashi, Toshimichi</p><p>Koda, Keiji</p><p>Koike, Yuhki</p><p>Komatsu, Shuhei</p><p>Konishi, Hirotaka</p><p>Kosuga, Toshiyuki</p><p>Kosumi, Keisuke</p><p>Koyama, Fumikazu</p><p>Koyanagi, Kazuo</p><p>Kubo, Shoji</p><p>Kubota, Takeshi</p><p>Kumagai, Koshi</p><p>Kumagai, Youichi</p><p>Kunisaki, Chikara</p><p>Kuroda, Shinji</p><p>Lee, Sang-Woong</p><p>Makino, Isamu</p><p>Manabe, Tatsuya</p><p>Marubashi, Shigeru</p><p>Maruyama, Suguru</p><p>Mats","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"211-213"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930483","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":"Palliative management for malignant biliary obstruction and gastric outlet obstruction from pancreatic cancer","authors":"Pengfei Wu,&nbsp;Kai Chen,&nbsp;Jin He","doi":"10.1002/ags3.12902","DOIUrl":"https://doi.org/10.1002/ags3.12902","url":null,"abstract":"<p>Pancreatic cancer is among the leading causes of gastrointestinal cancer-related death, with a dismal prognosis. Over 80% of pancreatic cancer patients present with advanced disease, making curative resection unfeasible. These patients are often presented with malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO). In these cases, palliative management is aimed to alleviate symptoms, enhance quality of life, and facilitate subsequent chemotherapy. Currently, neoadjuvant chemotherapy is frequently used in both borderline resectable and resectable pancreatic cancer, necessitating effective biliary and gastrointestinal drainage in a growing number of patients. Traditionally, surgical bypass was the gold standard, performed via either a minimally invasive or open approach. However, notable progress has emerged in developing endoscopic techniques, such as endoscopic retrograde cholangiopancreatography (ERCP) stenting for MBO and endoscopic enteral stenting for GOO. While these procedures provide rapid symptom relief, they are associated with higher stent dysfunction rates and more frequent re-intervention needs. When ERCP fails, percutaneous transhepatic biliary drainage is a widely accepted alternative for MBO. Endoscopic ultrasound (EUS)-guided techniques, including EUS-guided biliary drainage and EUS-guided gastroenterostomy, have recently gained prominence. Emerging clinical data suggest that these methods may be superior, potentially becoming the preferred first-line palliative treatment for unresectable pancreatic cancer. This review will summarize the current evidence on managing MBO and GOO in patients with pancreatic cancer.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 2","pages":"218-225"},"PeriodicalIF":2.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533373","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":"Survival benefit of adjuvant therapy completion with early initiation for patients with pancreatic ductal adenocarcinoma","authors":"Kenjiro Okada,&nbsp;Kenichiro Uemura,&nbsp;Tatsuaki Sumiyoshi,&nbsp;Ryuta Shintakuya,&nbsp;Kenta Baba,&nbsp;Takumi Harada,&nbsp;Yasutaka Ishii,&nbsp;Shiro Oka,&nbsp;Yoshiaki Murakami,&nbsp;Shinya Takahashi","doi":"10.1002/ags3.12898","DOIUrl":"https://doi.org/10.1002/ags3.12898","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the prognostic effect of initiation timing and completion of adjuvant therapy in patients with pancreatic ductal adenocarcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The medical records of patients with pancreatic ductal adenocarcinoma who underwent radical pancreatectomy between 2006 and 2022 at Hiroshima University were retrospectively reviewed. Patient characteristics, perioperative outcomes, clinicopathological factors, and survival rates were analyzed. Adjuvant indications were for all patients who had a good postoperative status as early as possible. Early initiation was defined as adjuvant initiation within 4 weeks after surgery, and completion was defined as a total of 6 months of administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 444 (294, resectable; 150, borderline resectable or locally advanced) patients who received adjuvant therapy were enrolled in this study. The median time to adjuvant therapy initiation was 20 days. In total, 328 patients with early initiation had better overall survival than those with delayed initiation, and 409 patients with adjuvant completion had better survival rates than those with incompletion. Multivariate overall survival analysis demonstrated that early adjuvant therapy initiation and completion were independent prognostic factors for prolonged survival. In total, 310 adjuvant completions with early initiation resulted in a median survival period of 81.8 months. Multivariate analysis identified severe postoperative complication as an independent risk factor preventing adjuvant completion with early initiation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adjuvant completion with early initiation may contribute to the improved survival of patients with pancreatic ductal adenocarcinoma. Preventing severe postoperative complications may facilitate adjuvant completion with early initiation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"785-793"},"PeriodicalIF":2.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12898","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520181","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":"Combined effect of frailty and sarcopenia on postoperative complications in older adults undergoing curative surgery for hepato-biliary-pancreatic cancer","authors":"Norifumi Harimoto,&nbsp;Keishi Sugimachi,&nbsp;Tomohiro F. Nishijima,&nbsp;Tomino Takahiro,&nbsp;Tomonari Shimagaki,&nbsp;Yohei Mano,&nbsp;Emi Onishi,&nbsp;Masahiko Sugiyama,&nbsp;Yasue Kimura,&nbsp;Masaru Morita","doi":"10.1002/ags3.12897","DOIUrl":"https://doi.org/10.1002/ags3.12897","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Older adults with cancer are often at increased risk for postoperative complications following major surgeries. This study aimed to evaluate the combined role of frailty and sarcopenia in predicting postoperative complications in older adults with hepatobiliary and pancreatic cancer undergoing surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 107 Japanese patients who underwent comprehensive geriatric assessment (CGA) at the geriatric oncology service before cancer treatment decisions and subsequent curative surgery for hepatobiliary and pancreatic cancer. Frailty status was measured using the validated 10-item frailty index based on a CGA (FI-CGA-10) and categorized as fit, prefrail, or frail. Sarcopenia was assessed using bioelectrical impedance analysis and grip strength. The primary outcome was postoperative complications, defined as Clavien–Dindo grade ≥ III, within 1 month of surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age of the 107 patients was 79 (range, 75–89) years. Patients were categorized as fit (<i>n</i> = 36, 33.7%), prefrail (<i>n</i> = 57, 53.2%), or frail (<i>n</i> = 14, 13.1%). Of these, 21 patients (20%) were diagnosed with sarcopenia; 16 patients (15%) experienced postoperative complications. Patients classified as prefrail or frail had a higher incidence of postoperative complications compared with those classified as fit (19.7% vs. 5.6%, <i>p</i> = 0.08). Patients with both prefrail or frail and sarcopenia had a significantly higher risk of postoperative complications. This association remained significant in the multivariable model (OR 4.74; 95% CI, 1.10–20.29; <i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this study, patients classified as prefrail/frail and sarcopenic were at significantly higher risk for postoperative complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"587-594"},"PeriodicalIF":2.9,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12897","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950332","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 on short-term outcomes of the COVID-19 pandemic following laparoscopic distal gastrectomy and low anterior resection for gastric and rectal cancer: A retrospective study using the Japanese National Clinical Database, 2018–2022","authors":"Masafumi Inomata,&nbsp;Hideki Endo,&nbsp;Tomonori Akagi,&nbsp;Hidefumi Shiroshita,&nbsp;Shigeki Yamaguchi,&nbsp;Susumu Eguchi,&nbsp;Norihito Wada,&nbsp;Yukinori Kurokawa,&nbsp;Yosuke Seki,&nbsp;Yoshiharu Sakai,&nbsp;Hiroyuki Yamamoto,&nbsp;Yoshihiro Kakeji,&nbsp;Yuko Kitagawa,&nbsp;Akinobu Taketomi,&nbsp;Masaki Mori","doi":"10.1002/ags3.12901","DOIUrl":"https://doi.org/10.1002/ags3.12901","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We previously reported no change in surgical outcomes for laparoscopic distal gastrectomy (LDG) and laparoscopic low anterior resection (LLAR) early in the COVID-19 pandemic (2020), although the number of elective surgeries decreased. In 2021, COVID-19 spread further, with vaccination and other medical measures based on several medical societies' guidelines being initiated. Using the Japanese National Clinical Database (NCD), we added 2022 data to the 2018–2021 data to analyze the impacts of expansion of the COVID-19 infection and its spread on laparoscopic surgery (including robot-assisted surgery).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on patients who underwent LDG and LLAR for cancer were extracted from the NCD between 2018 and 2022. The numbers of LDG and LLAR were obtained, and morbidity and mortality rates were evaluated using a standardized morbidity/mortality ratio (SMR), i.e. the ratio of the observed number of incidences to expected number of incidences calculated by the risk calculator previously developed by the NCD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The numbers of LDG and LLAR cases declined in 2020, the first pandemic year, and continued to decline in 2022 to the same level as 2021, but with no further decline and no recovery trend in the number of cases. Numbers of robot-assisted LDG and LLAR cases increased but at a rate lower than the prepandemic increase. Mortality and anastomotic leakage, two very important complications assessed in SMR, did not worsen during the pandemic compared to prepandemic levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In Japan, laparoscopic surgery was safe and unaffected by the COVID-19 pandemic, even in 2022, when the epidemic spread.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"619-627"},"PeriodicalIF":2.9,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12901","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950527","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":"Impacts of COVID-19 pandemic on short-term outcomes of low anterior resection performed in hospitals with different surgical volumes","authors":"Hiromichi Maeda,&nbsp;Hideki Endo,&nbsp;Ryo Seishima,&nbsp;Taizo Hibi,&nbsp;Masashi Takeuchi,&nbsp;Yusuke Takemura,&nbsp;Hiroyuki Yamamoto,&nbsp;Akinobu Taketomi,&nbsp;Yoshihiro Kakeji,&nbsp;Yasuyuki Seto,&nbsp;Hideki Ueno,&nbsp;Masaki Mori,&nbsp;Ken Shirabe,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12900","DOIUrl":"https://doi.org/10.1002/ags3.12900","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the impact of the coronavirus disease (COVID-19) pandemic on short-term outcomes of low anterior resection (LAR) across hospitals classified by surgical volume.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data of patients who underwent elective LAR for rectal cancer between 2018 and 2022 were obtained from the National Clinical Database of Japan. Hospitals were categorized into high-, medium-, and low-volume groups. Each group was constituted to represent approximately one-third of all surgeries performed between 2018 and 2019. The standardized morbidity/mortality ratios (SMRs) of Clavien–Dindo grade ≥3 (CD ≥ 3) complications were the primary endpoint. The secondary endpoints included anastomotic leakage, pneumonia, and surgical mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study analyzed 91 800 cases of elective LAR, with 10.5% experiencing CD ≥ 3 complications, 8.8% anastomotic leakage, 0.9% pneumonia, and 0.5% surgical mortality. Despite COVID-19, SMRs of CD ≥ 3 complications decreased from 2018 to 2022 across all groups. However, increases in the rates and SMRs of CD ≥ 3 complications were observed in low-volume hospitals around mid-2020, followed by a decline. Anastomotic leakage showed similar trends. The rates and SMRs of pneumonia and surgical mortality remained unchanged. Notably, anastomotic leakage rates were 7.6%, 8.9%, and 10.0% in high-, medium-, and low-volume hospitals, respectively, indicating superior outcomes in high-volume hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Early COVID-19 waves may have disproportionately affected low-volume hospitals. However, the decline in SMRs of CD ≥ 3 complications from 2018 to 2022 across all three groups suggests the robustness and resilience of surgical services for rectal cancer in Japan. The potential disparity in short-term outcomes among hospitals is a new concern.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"608-618"},"PeriodicalIF":2.9,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12900","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950547","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":"Treatment outcomes of hepatectomy and systemic chemotherapy based on oncological resectability criteria for hepatocellular carcinoma","authors":"Shohei Komatsu,&nbsp;Yoshihiko Yano,&nbsp;Nobuaki Ishihara,&nbsp;Masahiro Kido,&nbsp;Hidetoshi Gon,&nbsp;Kenji Fukushima,&nbsp;Takeshi Urade,&nbsp;Hiroaki Yanagimoto,&nbsp;Hirochika Toyama,&nbsp;Takumi Fukumoto","doi":"10.1002/ags3.12893","DOIUrl":"https://doi.org/10.1002/ags3.12893","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The oncological resectability criteria for hepatocellular carcinoma (HCC) have recently been established (R/BR1/BR2), and validating the outcomes is an urgent issue. This study aimed to analyze the outcomes of hepatectomy and systemic chemotherapy based on the oncological resectability criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 931 patients in the hepatectomy group and 273 in the systemic chemotherapy group who received atezolizumab/bevacizumab, lenvatinib, or durvalumab plus tremelimumab were recruited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median survival times (MST) in the hepatectomy group were R, 107.2 mo; BR1, 44.4 mo; and BR2, 18.4 mo (<i>p</i> &lt; 0.0001). The MSTs in the systemic chemotherapy group were R, 16.3 mo; BR1, 24.5 mo; and BR2, 16.1 mo (<i>p</i> = 0.3598). A comparison of survival of patients in the BR2 category revealed no significant difference between the two groups for those with modified albumin-bilirubin grade 1 + 2a (<i>p</i> = 0.7343) and grade 2b + 3 (<i>p</i> = 0.6589). The BR2 definition comprised three tumor factors, and the MST of patients with only one BR2-defining factor tended to be better in the hepatectomy group than in the systemic chemotherapy group (22.9 vs 20.2 mo, <i>p</i> = 0.0977). Meanwhile, the MST tended to be better in the systemic chemotherapy group than in the hepatectomy group (16.5 vs 12.6 mo) for those with two to three BR2-defining factors, although the difference was insignificant (<i>p</i> = 0.4252).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The oncological resectability criteria for HCC effectively stratified the prognosis after hepatectomy. Treatment outcomes of hepatectomy in patients with two to three BR2-defining factors are limited, suggesting the need for multidisciplinary treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 2","pages":"235-243"},"PeriodicalIF":2.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12893","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533425","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":"Bowel preparation and surgical site infections in laparoscopic and robot-assisted right-sided colon cancer surgery with intracorporeal anastomosis: A retrospective study","authors":"Naoya Ozawa,&nbsp;Tomohiro Yamaguchi,&nbsp;Takumi Kozu,&nbsp;Tatsuki Noguchi,&nbsp;Takashi Sakamoto,&nbsp;Shimpei Matsui,&nbsp;Toshiki Mukai,&nbsp;Takashi Akiyoshi,&nbsp;Yosuke Fukunaga","doi":"10.1002/ags3.12896","DOIUrl":"https://doi.org/10.1002/ags3.12896","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Previous studies have examined bowel preparation as a measure to reduce surgical site infection (SSI) rates. This retrospective study aimed to identify the risk factors for SSI in right-sided colon cancer surgery using intracorporeal anastomosis (IA). We focused on perioperative factors, including the bowel preparation method, to clarify the impact of preoperative mechanical bowel preparation (MBP) and oral antibiotics (OA) on SSI incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients (<i>n</i> = 150) with right-sided colon cancer who underwent elective laparoscopic or robot-assisted colectomy (2019 and 2023) were included. Potential risk factors for SSI were examined using univariate and multivariate analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall incidence of SSI was 11 (7.3%) cases, with eight (5.4%) cases classified as incision site SSI and three (1.9%) as organ/space SSI. Univariate analysis showed that OA (<i>p</i> &lt; 0.001) and MBP (<i>p</i> = 0.002) significantly reduced the SSI rate. Multivariate analysis identified OA as an independent risk factor (hazard ratio, 0.142; 95% confidence interval, 0.025–0.827; <i>p</i> = 0.025). Patients with SSI had longer postoperative hospital stays compared to those without SSI (median 9 vs. 8 days, <i>p</i> = 0.012). On postoperative day 1, the group receiving OA had significantly lower white blood cell count (9390 vs. 10 900/μL, <i>p</i> = 0.005) and C-reactive protein levels (3.81 vs. 7.83 mg/dL, <i>p</i> &lt; 0.001) compared to those in the group not receiving OA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative administration of OA in laparoscopic or robot-assisted right-sided colon cancer surgery with IA may help decrease the incidence of SSI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"711-718"},"PeriodicalIF":2.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519670","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 hepatospleno volume ratio on postoperative chronic liver failure after major hepatectomy for perihilar cholangiocarcinoma","authors":"Atsushi Takahashi,&nbsp;Yoshihiro Ono,&nbsp;Kosuke Kobayashi,&nbsp;Atsushi Oba,&nbsp;Takafumi Sato,&nbsp;Hiromichi Ito,&nbsp;Yosuke Inoue,&nbsp;Akio Saiura,&nbsp;Yu Takahashi","doi":"10.1002/ags3.12895","DOIUrl":"https://doi.org/10.1002/ags3.12895","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The incidence of postoperative chronic liver failure (PCLF) after major hepatectomy for perihilar cholangiocarcinoma is relatively low, but it warrants careful attention. This study aimed to analyze the risk factors for PCLF, with a specific focus on the correlation with postoperative changes in liver and spleen volumes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 172 patients who underwent major hepatectomy for perihilar cholangiocarcinoma between 2006 and 2021 were included in the study. PCLF is defined as the presence of liver failure, such as ascites, esophageal varices, encephalopathy, and jaundice at 3 mo postoperatively. Risk factors, including chronological changes in liver volume, spleen volume, and hepatospleno volume ratio for PCLF, were evaluated by univariate and multivariate analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PCLF occurred in 8 of the 172 patients. On univariate analysis, multiple factors including preoperative prealbumin levels, indocyanine green retention test, and future remnant liver volume were identified as risk factors for PCLF. On multivariate analysis, the hepatospleno volume ratio (<i>p</i> = 0.033) and prealbumin level (<i>p</i> = 0.015) 3 mo after surgery were significantly associated with PCLF. The cutoff value for the hepatospleno volume ratio was 3.0 (area under the curve [AUC]: 0.881, sensitivity: 91.7%, specificity: 66.7%) and that for prealbumin level was 10 mg/dL (AUC: 0.894, sensitivity: 83.3%, specificity: 88.9%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hepatospleno volume ratio &lt;3.0 and prealbumin level &lt;10 mg/dL 3 mo after surgery were identified as risk factors for PCLF, implying the importance of postoperative nutritional guidance to preserve the remnant liver function for patients with these risk factors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"578-586"},"PeriodicalIF":2.9,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12895","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949815","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":"Diagnosis of necrotic and non-necrotic small bowel strangulation: The importance of intestinal congestion","authors":"Takeshi Yamada,&nbsp;Yuto Aoki,&nbsp;Akihisa Matsuda,&nbsp;Yasuyuki Yokoyama,&nbsp;Goro Takahashi,&nbsp;Takuma Iwai,&nbsp;Seiichi Shinji,&nbsp;Hiromichi Sonoda,&nbsp;Kay Uehara,&nbsp;Hiroshi Yoshida","doi":"10.1002/ags3.12894","DOIUrl":"https://doi.org/10.1002/ags3.12894","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite the prevalence of laparoscopic techniques in abdominal surgeries today, bowel obstruction remains a potentially serious complication. Small bowel strangulation (SBS), in particular, is a critical condition that can lead to patient mortality. However, the prognosis for SBS is favorable if surgery is performed before the onset of necrosis. Non-necrotic SBS is a reversible condition in which blood flow can be restored by relieving the strangulation. The purpose of this study was to identify sensitive and specific contrast-enhanced computed tomography (CT) findings that are useful for diagnosis of both non-necrotic and necrotic SBS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included patients diagnosed with SBS and simple bowel obstruction (SBO) who underwent contrast-enhanced CT followed by surgery from 2006 to 2023. Two gastrointestinal surgeons independently assessed the images retrospectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty SBO and 141 SBS patients were included. Eighty-seven had non-necrotic SBS and 54 had necrotic SBS. Mesenteric edema was most frequently observed in both necrotic and non-necrotic SBS cases followed by abnormal bowel wall thickening. These two findings were observed significantly less frequently in SBO. Bowel hypo-enhancement is identified in only about half of the non-necrotic SBS cases, and it was detected at significantly higher rates in necrotic SBS compared to non-necrotic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Mesenteric edema and abnormal bowel wall thickening are sensitive and specific signs of both non-necrotic and necrotic SBS. These two findings indicate mesenteric and bowel congestion. Detecting intestinal congestion can lead to an accurate diagnosis of SBS, particularly in case of non-necrotic SBS, where bowel hypo-enhancement may sometimes be absent.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"538-545"},"PeriodicalIF":2.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950106","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}