Annals of Gastroenterological Surgery最新文献

{"title":"Possibly more favorable short-term outcomes with minimally invasive surgery than with open surgery in total gastrectomy for locally advanced gastric cancer: A single high-volume center study","authors":"Motonari Ri,&nbsp;Masaru Hayami,&nbsp;Manabu Ohashi,&nbsp;Rie Makuuchi,&nbsp;Tomoyuki Irino,&nbsp;Takeshi Sano,&nbsp;Souya Nunobe","doi":"10.1002/ags3.12881","DOIUrl":"https://doi.org/10.1002/ags3.12881","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Minimally invasive total gastrectomy (MTG) requires advanced surgical skills and is still associated with a higher rate of postoperative complications than other types of gastrectomy. Additionally, the short-term outcomes of MTG compared to open total gastrectomy (OTG) for locally advanced gastric cancer have yet to be demonstrated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively compared short-term outcomes between MTG and OTG for locally advanced gastric and esophago-gastric junctional cancer, performed at the Cancer Institute Hospital, Tokyo, during the period from January 2017 to March 2024. Propensity score matching (PSM) was conducted to adjust for potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 359 patients were included, with 190 remaining after PSM, resulting in 95 in each group. The MTG group experienced a significantly lower incidence of postoperative complications of Clavien–Dindo classification (C-D) ≥3 than the OTG group (3.2% vs. 11.6%, <i>p</i> = 0.026). Moreover, the rate of postoperative intra-abdominal infectious complications (IAIC) was significantly lower in the MTG than in the OTG group (C-D ≥ 2; 7.4% vs. 17.9%, <i>p</i> = 0.029 and C-D ≥ 3; 2.1% vs. 9.5%, <i>p</i> = 0.030, respectively). Subgroup analyses showed the odds ratios for IAIC with C-D ≥ 2 to be more favorable for the MTG than the OTG group in male patients, those ≥70 years of age, patients without esophageal invasion, those without neoadjuvant chemotherapy, those diagnosed with cT≥3, and patients not undergoing combined resection of other organs except for the gallbladder or spleen.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MTG for locally advanced gastric cancer may provide improved short-term outcomes compared to OTG, when performed or supervised by surgeons with high proficiency in laparoscopic techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"439-447"},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12881","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between surgical difficulty and tumor location based on subsegments of the Glisson branches in laparoscopic liver resection","authors":"Taisuke Imamura,&nbsp;Yusuke Yamamoto,&nbsp;Ryo Morimura,&nbsp;Hisashi Ikoma,&nbsp;Tomohiro Arita,&nbsp;Hirotaka Konishi,&nbsp;Atsushi Shiozaki,&nbsp;Takeshi Kubota,&nbsp;Hitoshi Fujiwara,&nbsp;Eigo Otsuji","doi":"10.1002/ags3.12879","DOIUrl":"https://doi.org/10.1002/ags3.12879","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Laparoscopic liver resection has a steep learning curve, and multiple difficulty-scoring systems have been proposed to support safe implementation. Though the IWATE scoring system is widely used, the rationale for its tumor location score is unclear. The objective of our study was to establish a more accurate definition of tumor location based on subsegments of the Glisson branches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 176 patients who underwent laparoscopic liver resection between January 2017 and February 2024, excluding those who underwent multiple or concomitant resections of other organs. Tumor location was defined by the most proximal subsegment of the Glisson branches (1sp, Spiegel; 1pc, para-caval; 1cp, caudate process; 3a, apical; 3b, basal; 4a; 4b; 5v, ventral; 5d, dorsal; 6v; 6d; 6 L, lateral; 7v; 7d; 8v; 8d).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Within each segment, comparing operative time between subsegments showed significant differences, except for S1 (3a vs. 3b, <i>p</i> = 0.011; 4a vs. 4b, <i>p</i> = 0.001; 5v vs. 5d, <i>p</i> = 0.012; 6v vs. 6d vs. 6 L, <i>p</i> = 0.007; 7v vs. 7d, <i>p</i> = 0.003; 8v vs. 8d, <i>p</i> = 0.030). Blood loss significantly differed except for S1 (3a vs. 3b, <i>p</i> = 0.018; 4a vs. 4b, <i>p</i> = 0.002; 5v vs. 5d, <i>p</i> = 0.016; 6v vs. 6d vs. 6 L, <i>p</i> = 0.011; 7v vs. 7d, <i>p</i> = 0.013; 8v vs. 8d, <i>p</i> &lt; 0.001). The incidence of postoperative complications did not differ significantly; however, hospital stay was significantly different only in S4 (4a vs. 4b, <i>p</i> = 0.049).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There are significant differences in the difficulty of laparoscopic liver resection among subsegments. More detailed scoring based on subsegments may improve accuracy, and we propose a new scoring system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"546-558"},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12879","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of surgical treatment in elderly patients with ulcerative colitis-associated colorectal cancer: A subanalysis of a nationwide Japanese multicenter study","authors":"Kinuko Nagayoshi,&nbsp;Yusuke Mizuuchi,&nbsp;Masafumi Nakamura,&nbsp;Koji Okabayashi,&nbsp;Motoi Uchino,&nbsp;Hiroki Ikeuchi,&nbsp;Tatsuki Noguchi,&nbsp;Soichiro Ishihara,&nbsp;Yoichi Ajioka,&nbsp;Kenichi Sugihara,&nbsp;from the Study Group for Inflammatory Bowel Disease Associated Intestinal Cancers by the Japanese Society for Cancer of the Colon and Rectum","doi":"10.1002/ags3.12885","DOIUrl":"https://doi.org/10.1002/ags3.12885","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Our study aimed to examine the characteristics of elderly patients diagnosed with ulcerative colitis-associated colorectal cancer (UAC) and evaluate the impact of surgical intervention on prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 1086 patients diagnosed with UAC between 1980 and 2020 were retrospectively enrolled. Data were collected through the Japanese Society for Cancer of the Colon and Rectum project. The patients were divided into two groups: 248 elderly patients in the E-UAC group and 838 nonelderly patients in the NE-UAC group. Patients aged &gt;65 y at cancer diagnosis were considered elderly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The recurrence rate did not differ between the two groups. Segmental resection was the only common independent risk factor for recurrence in both the E-UAC and the NE-UAC groups. The E-UAC patients had significantly better 5-y disease-specific survival (DSS) than the NE-UAC patients (94.7% vs 91.0%, <i>p</i> = 0.04). There were no differences in 5-y recurrence-free survival (RFS; 89.3% vs 86.6%, respectively, <i>p</i> = 0.24) or overall survival (OS; 88.8% vs 89.6%, <i>p</i> = 0.50). The E-UAC patients who underwent segmental resection had poorer RFS than those who underwent total proctocolectomy, but there were no significant differences in DSS or OS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite the elevated risk of cancer recurrence observed in the UAC patients who underwent segmental resection in both the E-UAC the NE-UAC groups, our findings suggested that segmental resection may be a viable alternative to total proctocolectomy in terms of survival rate for the E-UAC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"486-495"},"PeriodicalIF":2.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12885","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of risk factors for postoperative complications after right colectomy and low anterior resection in patients ≥85 years old with colorectal cancer using the National Clinical Database","authors":"Tomonori Akagi,&nbsp;Shiori Nishimura,&nbsp;Yoshitake Ueda,&nbsp;Masafumi Inomata,&nbsp;Hidefumi Shiroshita,&nbsp;Shuji Takiguchi,&nbsp;Yoshiharu Sakai,&nbsp;Hiraku Kumamaru,&nbsp;Hideki Ueno,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12876","DOIUrl":"https://doi.org/10.1002/ags3.12876","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The purpose of this study was to evaluate factors associated with surgical outcomes and postoperative complications (Grade ≥3 by Clavien–Dindo classification) of right hemicolectomy (RH) and low anterior resection (LAR) for colorectal cancer in patients ≥85 years old.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed National Clinical Database (NCD) data on patients aged ≥85 years who underwent RH and LAR for colorectal cancer between 2017 and 2020. All possible preoperative factors were used to explore the risk factors for serious postoperative complication in these very elderly patients with colorectal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For RH, the operative mortality rate was 1.1% (98 cases), and the rate of serious postoperative complications was 5.2% (480 cases). Similarly, the mortality rate was 1.1% (27 cases), and the rate of serious complications (Clavien–Dindo Grade ≥3) was 8.7% (206 cases) for LAR. Based on multivariate analysis, independent risk factors for serious postoperative complications were male sex, ADL (partially dependent), hypertension, platelets (&lt;150 000/μL), serum Na (&lt;138 mEq/L), and PT-INR (&gt;1.1) for RH, and ASA-PS (Grade ≥3), history of pneumonia, creatinine (&gt;1.2 mg/day), and serum Na (&lt;138 mEq/L) for LAR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present results for RH and LAR suggest that surgical treatment for patients aged ≥85 years old is safe and feasible. Surgeons need to pay special attention more to physical status and past medical history than to tumor factors to prevent serious postoperative complications in these older patients with colorectal cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 2","pages":"329-338"},"PeriodicalIF":2.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12876","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updated risk prediction model for pancreaticoduodenectomy using data from the National Clinical Database in Japan","authors":"Masamichi Mizuma,&nbsp;Hideki Endo,&nbsp;Hiroyuki Yamamoto,&nbsp;Mitsuhiro Shimura,&nbsp;Masahiro Iseki,&nbsp;Michiaki Unno,&nbsp;Taro Oshikiri,&nbsp;Yoshihiro Kakeji,&nbsp;Ken Shirabe","doi":"10.1002/ags3.12883","DOIUrl":"https://doi.org/10.1002/ags3.12883","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Risk prediction models for mortality, severe postoperative complications, and postoperative pancreatic fistula in patients undergoing pancreaticoduodenectomy were established using data from the National Clinical Database more than a decade ago, and the surgical outcomes of pancreaticoduodenectomy have improved over the years. The aim of this study is to update the risk prediction model for pancreaticoduodenectomy using National Clinical Database data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between 2019 and 2021, the data of 35 365 patients who underwent pancreaticoduodenectomy and who were registered in the National Clinical Database were retrospectively analyzed. According to the registration year, the patients were divided into two cohorts: the development cohort (2019–2020; <i>n</i> = 23 654) and the validation cohort (2021; <i>n</i> = 11 711). Logistic regression analyses were performed to create risk models for surgical mortality, severe postoperative complications, and grade C postoperative pancreatic fistula.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, the rates of surgical mortality, severe postoperative complications, and grade C postoperative pancreatic fistula were 1.8%, 2.2%, and 1.3%, respectively. Logistic regression analyses revealed 28, 28, and 14 risk factors for surgical mortality, severe postoperative complications, and grade C postoperative pancreatic fistula, respectively. The area under the receiver operating characteristic curve of the risk model in the development cohort was 0.759 for surgical mortality, 0.712 for severe complications, and 0.699 for postoperative pancreatic fistula, comparable to the validation cohort. The calibration plots were favorable in both cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The updated risk model for pancreaticoduodenectomy will be useful to predict surgical mortality, severe postoperative complications, and grade C postoperative pancreatic fistula.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"559-568"},"PeriodicalIF":2.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12883","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949740","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 stratification of residual abscess after surgical treatment for gastroduodenal perforation","authors":"Kana Ishikawa,&nbsp;Siyuan Yao,&nbsp;Takashi Kumode,&nbsp;Keisuke Tanino,&nbsp;Yugo Matsui,&nbsp;Shusaku Honma,&nbsp;Shinichi Hosokawa,&nbsp;Teppei Murakami,&nbsp;Takatsugu Kan,&nbsp;Sanae Nakajima","doi":"10.1002/ags3.12877","DOIUrl":"https://doi.org/10.1002/ags3.12877","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Residual abscess is a major complication after emergency surgery for gastroduodenal (GD) perforation. However, there is little evidence regarding potential risk factors contributing to its development. Establishing a risk stratification strategy would be valuable for the entire management process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective study analyzed 115 consecutive patients who underwent surgery for GD perforation between 2010 and 2023 at a secondary emergency care hospital. Patients were divided into two groups based on the presence or absence of residual abscesses. Potential risk factors for abscess formation were evaluated from various aspects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence of residual abscesses was 19.1% (22 of 115). Multivariable analysis revealed that current use of nonsteroidal antiinflammatory drugs (odds ratio [OR] 3.76, <i>p</i> = 0.037), cancer chemotherapy (OR 13.56, <i>p</i> = 0.005), and preoperative renal dysfunction (OR 4.72, <i>p</i> = 0.018) were independent predictors. A potential scoring model could be created using these three parameters, and the number of risk factors correlated with the likelihood of developing a residual abscess (0 vs. 1 vs. ≥2; 6.2% vs. 29.4% vs. 50.0%, <i>p</i> &lt; 0.001). From a bacteriological point of view, the presence of <i>Enterococcus</i> in the ascites culture was closely related to its occurrence with 100% probability. Moreover, regarding early detection of this complication, C-reactive protein on postoperative d 5 had the highest predictive ability with an area under the curve of 0.818.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The risk of residual abscess formation after surgical treatment of GD perforation can be assessed utilizing both preoperative and postoperative information.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 2","pages":"263-270"},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12877","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535999","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 gastrectomy on efficacy and safety of second-line chemotherapy patients with advanced gastric cancer: Exploratory analysis of two randomized phase III trials","authors":"Kazuhiro Nishikawa,&nbsp;Wasaburo Koizumi,&nbsp;Akira Tsuburaya,&nbsp;Motoko Suzuki,&nbsp;Satoshi Morita,&nbsp;Kazumasa Fujitani,&nbsp;Yusuke Akamaru,&nbsp;Ken Shimada,&nbsp;Hisashi Hosaka,&nbsp;Ken Nishimura,&nbsp;Takaki Yoshikawa,&nbsp;Toshimasa Tsujinaka,&nbsp;Junichi Sakamoto","doi":"10.1002/ags3.12880","DOIUrl":"https://doi.org/10.1002/ags3.12880","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Second-line chemotherapy (SLC) improves survival in advanced gastric cancer (AGC). Although many patients receiving SLC have undergone gastrectomy, the impact of gastrectomy on SLC remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>The objective was to evaluate the impact of gastrectomy on SLC for AGC. A total of 290 eligible patients registered in two randomized phase III trials evaluating SLC for patients with AGC was classified into the prior gastrectomy group (PGG; <i>n</i> = 187) or the no gastrectomy group (NGG; <i>n</i> = 103). We compared overall survival (OS), progression-free survival (PFS), overall response rate (ORR), disease control rate (DCR), and safety between these two groups. Adjusted OS and adjusted PFS were estimated using inverse probability of treatment weighting (IPTW).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The PGG had better performance status (<i>p</i> = 0.001), more prior platinum agent (<i>p</i> &lt; 0.001), and more frequent peritoneal metastasis (<i>p</i> = 0.006) than the NGG. The PGG had significantly better OS (13.8 vs. 9.3 mo; hazard ratio [HR]: 0.59; <i>p</i> &lt; 0.001) and PFS (4.7 vs. 2.8 mo; HR: 0.58; <i>p</i> &lt; 0.001) than the NGG. The PGG had significantly better adjusted OS (13.8 vs. 10.0 mo; IPTW HR: 0.66; <i>p</i> = 0.01) and adjusted PFS (4.3 vs. 3.2 mo; IPTW HR: 0.71; <i>p</i> = 0.027) than the NGG. No significant differences were observed in ORR and DCR. The incidence of Grade 3 or worse adverse events did not differ between the two groups except for a high incidence of anemia and diarrhea in the NGG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with previous gastrectomy are expected to have better survival outcomes when receiving second-line irinotecan (IRI)-based chemotherapy for AGC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"429-438"},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12880","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950091","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 autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgery","authors":"Sodai Arai,&nbsp;Hiroyasu Kagawa,&nbsp;Akio Shiomi,&nbsp;Yusuke Yamaoka,&nbsp;Shoichi Manabe,&nbsp;Chikara Maeda,&nbsp;Yusuke Tanaka,&nbsp;Shunsuke Kasai,&nbsp;Akifumi Notsu,&nbsp;Yusuke Kinugasa","doi":"10.1002/ags3.12878","DOIUrl":"https://doi.org/10.1002/ags3.12878","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We investigated whether autonomic nervous system resection during robotic rectal surgery contributes to urinary dysfunction and to what extent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included patients who underwent rectal surgery for primary rectal cancer between December 2011 and April 2021. We identified urinary dysfunction risk factors and examined the effect of autonomic nervous system resection extent on urinary dysfunction occurrence, with urinary dysfunction defined as a residual urine volume of &gt;50 mL. Urinary dysfunction with no improvement over 1 y was defined as permanent urinary dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1017 eligible patients, 78 (7.7%) required autonomic nervous system resection. Lateral lymph node dissection was performed in 357 patients (35.1%). Urinary dysfunction was observed in 102 patients (10.0%). We studied 32 (41.0%) of 78 patients who underwent autonomic nervous system resection and 82 (23.0%) of 357 patients who underwent lateral lymph node dissection presented with urinary dysfunction. Multivariate analysis revealed that lateral lymph node dissection and autonomic nervous system resection were significant predictors of urinary dysfunction. The urinary dysfunction incidence was notably higher in patients with autonomic nervous system unilateral total resection of at least one side than in those with bilateral preservation (65.4% vs. 28.8%, <i>p</i> &lt; 0.01), and permanent urinary dysfunction exclusively occurred in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In robotic surgery, autonomic nervous system resection and lateral lymph node dissection were independent risk factors for urinary dysfunction. Furthermore, the extent of autonomic nervous system resection may increase the risk of permanent urinary dysfunction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"476-485"},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12878","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143950092","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":"Helicobacter pylori prevalence and its spontaneous eradication rate after distal or proximal gastrectomy for gastric cancer: A multicenter prospective cohort study","authors":"Takeshi Omori,&nbsp;Tsuyoshi Takahashi,&nbsp;Yukinori Kurokawa,&nbsp;Toru Masuzawa,&nbsp;Yusuke Akamaru,&nbsp;Masaaki Motoori,&nbsp;Takuro Saito,&nbsp;Kazuyoshi Yamamoto,&nbsp;Kazuhiro Nishikawa,&nbsp;Hiroshi Imamura,&nbsp;Atsushi Takeno,&nbsp;Ryohei Kawabata,&nbsp;Yoshiyuki Fujiwara,&nbsp;Hidetoshi Eguchi,&nbsp;Yuichiro Doki","doi":"10.1002/ags3.12860","DOIUrl":"https://doi.org/10.1002/ags3.12860","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication is recommended in patients undergoing endoscopic resection for early gastric cancer to reduce recurrence. However, due to the possibility of spontaneous regression secondary to dynamic changes in the remnant stomach, the immediate eradication after gastrectomy for <i>H. pylori</i> carriers remains unclear. This study aimed to investigate the prevalence of <i>H. pylori</i> in Japanese patients with gastric cancer and the spontaneous eradication rate after distal or proximal gastrectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter prospective cohort study was conducted at 22 institutions. Eligibility criteria was patients over 20 years planned to undergo R0 gastrectomy for gastric cancer. The primary endpoint was spontaneous eradication rate 1 year after distal or proximal gastrectomy. The prevalence of <i>H. pylori</i> infection before surgery and clinical features related to spontaneous eradication were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1247 patients were included in this study. The preoperative <i>H. pylori</i> status was positive in 756 patients and negative in 491. Seventy-nine of the negative patients had an eradication history, totaling 835 (67%) patients preoperatively infected with <i>H. pylori</i>. The infection status of 541 patients was examined 1 year postoperatively; 285 were negative, with a 52.7% spontaneous eradication rate. Spontaneous eradication was significantly higher in male and older patients (&gt;70 years); other factors, such as histological type, gastrectomy method and adjuvant chemotherapy presence, did not affect the rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>As spontaneous <i>H. pylori</i> eradication occurred in more than half of the analyzed patients, retesting for <i>H. pylori</i>. should be considered before postoperative eradication therapy (UMIN000020280).</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 2","pages":"244-250"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12860","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic relevance of sarcopenia and tumor-infiltrating CD8+ T cells in patients with hepatocellular carcinoma","authors":"Shunsuke Doi,&nbsp;Satoshi Yasuda,&nbsp;Miu Miyashita,&nbsp;Minako Nagai,&nbsp;Kota Nakamura,&nbsp;Yasuko Matsuo,&nbsp;Taichi Terai,&nbsp;Yuichiro Kohara,&nbsp;Takeshi Sakata,&nbsp;Masayuki Sho","doi":"10.1002/ags3.12875","DOIUrl":"https://doi.org/10.1002/ags3.12875","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The relationship between sarcopenia, tumor-infiltrating lymphocytes (TILs), and long-term survival in patients with hepatocellular carcinoma (HCC) has not been investigated. We aimed to evaluate the prognostic relevance of sarcopenia and TILs in patients with HCC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 351 patients with HCC following liver resection. Sarcopenia was defined based on the skeletal muscle index using computed tomography. Tumor-infiltrating CD4⁺ and CD8⁺ T cells, perforin, and granzyme B were examined in liver resection specimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sarcopenia patients had a significantly lower lymphocyte count (<i>p</i> = 0.003), prognostic nutritional index (<i>p</i> = 0.017), and CD4⁺ and CD8⁺ T cell counts (<i>p</i> = 0.008 and <i>p</i> = 0.006, respectively). The overall survival (OS) and recurrence-free survival (RFS) rates of sarcopenia patients were significantly lower than non-sarcopenia patients (both <i>p</i> &lt; 0.001). Multivariate analysis revealed that sarcopenia and low CD8 levels were strong independent poor prognostic factors for OS and RFS (both <i>p</i> &lt; 0.001). Regardless of sarcopenia, patients with high CD8 levels had significantly better OS and RFS rates and increased expression of perforin and granzyme B. Particularly, sarcopenia patients with high CD8 levels had much better OS and RFS than those with low CD8 levels and were even comparable to non-sarcopenia patients with high CD8 levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sarcopenia and low CD8 levels are strong independent poor prognostic factors in patients with HCC. Furthermore, sarcopenia patients with high CD8 levels had favorable survival and activated local immunity, suggesting that tumor-infiltrating CD8⁺ T cells may play a functionally important role in sarcopenia patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 2","pages":"359-368"},"PeriodicalIF":2.9,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12875","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536033","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}