Annals of Gastroenterological Surgery最新文献

{"title":"Risk factors for postoperative complications in laparoscopic and robot-assisted surgery for octogenarians with colorectal cancer: A multicenter retrospective study","authors":"Takehito Yamamoto,&nbsp;Koya Hida,&nbsp;Kentaro Goto,&nbsp;Meiki Fukuda,&nbsp;Susumu Inamoto,&nbsp;Hiroki Hashida,&nbsp;Ryo Matsusue,&nbsp;Ryo Takahashi,&nbsp;Rei Mizuno,&nbsp;Hiroaki Terajima,&nbsp;Kazutaka Obama","doi":"10.1002/ags3.12874","DOIUrl":"https://doi.org/10.1002/ags3.12874","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Minimally invasive surgery for colorectal cancer is increasing globally. However, the safety in older patients have not been thoroughly examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with colorectal cancer who underwent laparoscopic or robot-assisted surgery at Kyoto University Hospital and 18 affiliated institutions in Japan that participated in the Kyoto Colorectal Surgery Group between 2018 and 2023 were enrolled. Focusing on patients ≥80 y, we investigated the risk factors for postoperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 7303 patients were enrolled in this study. The mean age was 71 ± 11 y, with 1665 patients (22.8%) ≥80 y old. Older patients (≥80 y) had significantly higher ASA and ECOG-PS scores and more comorbidities including diabetes, chronic obstructive pulmonary disease (COPD), hypertension, heart disease, and cerebrovascular disease than patients ≤79 y old (all <i>p</i> &lt; 0.05). In the older group, postoperative complications (Clavien–Dindo grade ≥II) occurred in 210 patients (12.6%). After adjusting for covariates using the multivariable logistic regression model, rectal cancer (odds ratio [OR]: 1.84, 95% confidence interval [CI]: 1.30–2.60, <i>p</i> = 0.001), operation time ≥300 min (OR: 1.52, 95% CI: 1.07–2.16, <i>p</i> = 0.020), and blood loss ≥100 mL (OR: 2.19, 95% CI: 1.80–3.24, <i>p</i> &lt; 0.001) were associated with the occurrence of complications, whereas their comorbidities showed no association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In minimally invasive colorectal cancer surgery for older patients (≥80 y old), prioritizing shorter operation time and blood loss control is crucial, especially for patients with rectal cancer because of their high risk of complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 2","pages":"319-328"},"PeriodicalIF":2.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12874","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143533376","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":"Effects of an increase in emergency cases with difficulties in transport to hospital during the COVID-19 pandemic on postoperative short-term outcomes of colorectal perforation: A study based on the National Clinical Database","authors":"Shimpei Ogawa,&nbsp;Hideki Endo,&nbsp;Masahiro Yoshida,&nbsp;Tomomitsu Tsuru,&nbsp;Michio Itabashi,&nbsp;Hiroyuki Yamamoto,&nbsp;Yoshihiro Kakeji,&nbsp;Hideki Ueno,&nbsp;Ken Shirabe,&nbsp;Taizo Hibi,&nbsp;Akinobu Taketomi,&nbsp;Norihiko Ikeda,&nbsp;Masaki Mori","doi":"10.1002/ags3.12887","DOIUrl":"https://doi.org/10.1002/ags3.12887","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>During the COVID-19 pandemic, there were delays in transport of emergency cases to hospital by ambulance due to increased difficulties in obtaining hospital acceptance. The aim of this study was to examine if this had a negative effect on postoperative short-term outcomes in patients with colorectal perforation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The National Clinical Database (NCD) includes &gt;95% of surgical cases in Japan. Postoperative 30-day mortality, surgical mortality, and postoperative complications (Clavien–Dindo grade ≥3) were examined in 17 770 cases of colorectal perforation registered from 2019 to 2022 in the NCD. These outcomes were compared for cases with new COVID-19 infection and emergency cases with difficulties in transport to hospital. Months were considered to have significantly high or low mortality or complication rates, if the 95% confidence interval (CI) of the standardized mortality (morbidity) ratio (SMR) did not contain 1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Postoperative 30-day mortality occurred in 1826 cases (10.3%), surgical mortality in 2382 cases (13.4%), and postoperative complications in 5276 cases (29.7%). Significantly higher SMRs were found for 30-day mortality in November 2020 (1.44 [95% CI: 1.07–1.89]) and February 2021 (1.54 [95% CI: 1.14–2.03]), and for postoperative complications in June 2020 (1.27 [95% CI: 1.07–1.50]). In 2022, there were marked increases in new COVID-19 cases and in emergency cases with difficulties in transport to hospital, but no month had a significantly high SMR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Emergency cases with difficulties in transport markedly increased during the COVID-19 pandemic but had little effect on short-term outcomes of colorectal perforation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"505-517"},"PeriodicalIF":2.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12887","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950243","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":"Nationwide medical database study for postoperative nutritional management in patients undergoing gastroenterological cancer surgery","authors":"Yoshikuni Kawaguchi,&nbsp;Kenta Murotani,&nbsp;Nahoki Hayashi,&nbsp;Satoru Kamoshita","doi":"10.1002/ags3.12892","DOIUrl":"https://doi.org/10.1002/ags3.12892","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The study aimed to clarify how nutrition was managed in patients based on surgical site during the first 7 d after gastroenterological cancer surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Japanese medical claims database was used to identify patients who had gastroenterological cancer surgery from 2011 to 2022. Patients were divided into groups based on the surgical sites, and postoperative feeding routes and timing of initiation of oral intake for groups were assessed. For the subset of patients fasting postoperatively for ≥7 d, the proportion of patients prescribed target doses of energy (20 kcal/kg) and amino acids (0.8 g/kg) on postoperative d 7 were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Surgical sites of 360 296 study patients were: esophagus, 14 784; stomach, 103 339; colon/rectum, 194 049; liver, 19 277; gallbladder/bile duct, 8279; pancreas, 20 568. The median postoperative day of oral intake initiation was: esophagus, seven; stomach and pancreas, four; colon/rectum and gallbladder/bile duct, three; liver, two. The proportions of fasting patients prescribed target doses of energy and amino acids on postoperative d 7 were: esophagus, 42.6% and 34.4%; stomach, 21.8% and 28.0%; colon/rectum, 20.9% and 29.1%; liver, 21.2% and 22.5%; gallbladder/bile duct, 31.0% and 33.4%; pancreas, 28.2% and 37.8%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Oral intake after gastroenterological cancer surgery was started earliest in patients undergoing liver surgery and latest in patients undergoing esophageal surgery. Target parenteral energy and amino acid doses were prescribed to less than half of fasting patients. Education is needed to promote early initiation of oral intake and the use of guidelines-based parenteral nutrition dosing in patients after gastroenterological cancer surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"595-607"},"PeriodicalIF":2.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12892","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950244","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":"Analysis of surgical volume and short-term outcomes for upper gastrointestinal cancer post-COVID-19: Evidence from a nationwide Japanese database","authors":"Masashi Takeuchi,&nbsp;Hideki Endo,&nbsp;Taizo Hibi,&nbsp;Ryo Seishima,&nbsp;Yusuke Takemura,&nbsp;Hiroyuki Yamamoto,&nbsp;Hiromichi Maeda,&nbsp;Akinobu Taketomi,&nbsp;Yoshihiro Kakeji,&nbsp;Yasuyuki Seto,&nbsp;Hideki Ueno,&nbsp;Masaki Mori,&nbsp;Ken Shirabe,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12891","DOIUrl":"https://doi.org/10.1002/ags3.12891","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Previous studies indicated that short-term outcomes for gastroenterological surgeries did not worsen during the COVID-19 pandemic. However, it remains unclear whether surgical volumes and medical resource use have recovered postpandemic. This study examines pre- and postpandemic trends in upper gastrointestinal surgeries, including esophagectomy and gastrectomy, and their short-term outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the Japan's National Clinical Database (NCD) were analyzed for patients who underwent esophagectomy for esophageal cancer and gastrectomy for gastric cancer between January 2018 and December 2023. We evaluated changes in surgical volume, intensive care unit (ICU) use, morbidity, mortality rates, and the standardized morbidity and mortality ratio (SMR)—a comparison of observed versus expected outcomes using an NCD-established risk calculator. Key metrics included 30d mortality, surgical mortality, and four major morbidities like pneumonia and anastomotic leakage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Esophagectomy volumes remained stable from 2018 to 2023, while gastrectomy volumes decreased notably over the past 6 y. The proportion of patients over 70 increased significantly in both surgery types. Morbidity and mortality rates showed no significant deterioration postpandemic, as indicated by SMR values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study analyzed changes in surgical volume and short-term outcomes for upper gastrointestinal cancer in the post-COVID-19 era using a Japanese nationwide database. It found that surgical treatments for gastrectomy and esophagectomy remained safe even after the pandemic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"448-455"},"PeriodicalIF":2.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950551","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":"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}