Annals of Gastroenterological Surgery最新文献

{"title":"y-shaped side overlap esophagogastrostomy in proximal gastrectomy","authors":"Yukinori Kurokawa,&nbsp;Takuro Saito,&nbsp;Kazuyoshi Yamamoto,&nbsp;Tsuyoshi Takahashi,&nbsp;Yuichiro Doki","doi":"10.1002/ags3.12859","DOIUrl":"10.1002/ags3.12859","url":null,"abstract":"<p>Several reconstruction methods are used in proximal gastrectomy. Esophagogastrostomy is the simplest and most physiological. The challenge in esophagogastrostomy is preventing reflux esophagitis. Various techniques have been developed to reduce reflux of gastric juice. Taking advantage of the usefulness of the recently reported modified side overlap with fundoplication by Yamashita (mSOFY) method, we developed a y-shaped mSOFY method that is simpler and has potential for a greater anti-reflux effect. Unlike the original mSOFY method, the pseudo-fornix does not go behind the esophagus and the axes of the esophagus and residual stomach are shifted by approximately 60° to form a “y” shape. In addition, fixation of the residual stomach and both sides of the esophagus and crus of the diaphragm is performed at the end of the procedure. We performed 12 cases of laparoscopic or robotic proximal gastrectomy with y-shaped mSOFY esophagogastric anastomosis located below the crus of the diaphragm for gastric or esophagogastric junction adenocarcinoma between August 2021 and March 2023. The median operative time and blood loss were 260 min and 5 mL, respectively. No postoperative complications of Clavien–Dindo classification grade II or higher occurred. No stenoses requiring balloon dilation occurred within 1 year after surgery, but endoscopy at 1 year after surgery revealed two cases (17%) of reflux esophagitis of Los Angeles grade B or higher. In conclusion, this y-shaped side overlap esophagogastrostomy method could be one of the recommended esophagogastrostomy procedures in proximal gastrectomy.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"205-210"},"PeriodicalIF":2.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930576","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":"Robotic esophagectomy with function-preserving radical mediastinal lymphadenectomy for esophageal cancer","authors":"Raja Kalayarasan,&nbsp;Pothugunta Sai Krishna","doi":"10.1002/ags3.12862","DOIUrl":"10.1002/ags3.12862","url":null,"abstract":"<p>Radical lymphadenectomy is the critical component of surgery for esophageal cancer. However, lymphadenectomy significantly contributes to postoperative morbidity, particularly in terms of pulmonary complications following esophagectomy. Function-preserving mediastinal lymphadenectomy seeks to balance the procedure's necessary radicality and optimal functional outcomes. This approach emphasizes the preservation of the thoracic duct, tracheobronchial vascularity, and the pulmonary and recurrent laryngeal branches of the vagus nerve. Preservation of the thoracic duct is facilitated by indocyanine green fluorescence. Compared to the conventional technique of thoracic duct identification using anatomical landmarks, indocyanine green fluorescence lymphangiography offers real-time feedback, making it particularly advantageous in cases with complex anatomy or when the thoracic duct is challenging to visualize using conventional methods. Preservation of pulmonary branches of the right vagus during subcarinal lymphadenectomy and left recurrent laryngeal nerve during left paratracheal node dissection are technically challenging. The description of two types of left recurrent laryngeal nerve node dissection and technical tips for nerve function preservation are outlined in this review. Intraoperative neuromonitoring is a useful adjunct for nerve-sparing mediastinal lymphadenectomy. As ischemia to the respiratory tract impairs respiratory protective mechanisms, preservation of the tracheobronchial blood supply is critical. Preoperative imaging to detect bronchial artery anatomical variations and intraoperative assessment of perfusion using laser doppler flowmetry and indocyanine green fluorescence angiography are useful strategies to minimize tracheobronchial ischemia. Function-preserving mediastinal lymphadenectomy has the potential to improve short- and long-term outcomes after esophagectomy for esophageal cancer.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"12-23"},"PeriodicalIF":2.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930545","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":"Laparoscopic median arcuate ligament release using an anterior approach for median arcuate ligament syndrome","authors":"Koji Kubota,&nbsp;Akira Shimizu,&nbsp;Tsuyoshi Notake,&nbsp;Satoshi Nakamura,&nbsp;Yuji Soejima","doi":"10.1002/ags3.12858","DOIUrl":"10.1002/ags3.12858","url":null,"abstract":"<p>Median arcuate ligament syndrome (MALS) is a rare condition characterized by nonspecific symptoms, such as abdominal pain, nausea, and vomiting. Furthermore, the development and rupture of pancreaticoduodenal artery aneurysms pose a potentially fatal risk. Median arcuate ligament release (MALR) is useful in the treatment of MALS, with most procedures performed laparoscopically. However, detailed descriptions of laparoscopic MALR (lap-MALR) procedures are rare. In this study, we performed lap-MALR via an anterior approach with dissection of the right lateral wall of the celiac artery (CA). For optimal visualization of the right side of the CA, the right branch of the inferior phrenic artery was divided. We believe that this procedure allows the MAL to be released within a sufficient surgical field and without excess or deficiency. Here, we present the details of six patients who underwent lap-MALR for varying indications; three for pancreaticoduodenal artery aneurysms due to CA obstruction (unruptured, <i>n</i> = 1; ruptured, <i>n</i> = 2), two cases prior to hepato-biliary-pancreatic surgery, and one symptomatic case. In all cases, lap-MALR was performed as described above, and the CA stenosis was successfully released. Our case series demonstrates the safety and reliability of our lap-MALR procedure in the treatment of MALS-related disorders, including pancreaticoduodenal artery aneurysms associated with CA compression.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 6","pages":"1137-1143"},"PeriodicalIF":2.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142580797","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":"Robotic right-sided colon cancer surgery: Dissecting the outermost layer of the autonomic nerve along the superior mesenteric artery","authors":"Dai Shida,&nbsp;Yuka Ahiko,&nbsp;Naoki Sakuyama,&nbsp;Satoko Monma,&nbsp;Shigehiro Kojima","doi":"10.1002/ags3.12861","DOIUrl":"10.1002/ags3.12861","url":null,"abstract":"<p>In right-sided colon cancer surgery, lymph node dissection around the superior mesenteric artery is necessary but technically challenging. Here we introduce the concept of “outermost layer-oriented robotic surgery” to improve the safety, efficacy, and reproducibility of superior mesenteric artery nodal dissection. In this procedure, the thin, loose connective tissue layer between the autonomic nerve sheath of the superior mesenteric artery and adipose tissue bearing lymph nodes, termed “the outermost layer of the autonomic nerve,” is dissected. The procedure exposes the outermost layer of the nerve plexus covering the surface of the superior mesenteric artery with a width of approximately 1 cm, enabling direct visualization of the anatomy of the main arteries and, if they exist, jejunal veins which cross the superior mesenteric artery ventrally. This allows for sufficient dissection of main lymph nodes at the roots of the ileocolic artery, right colic artery, and middle colic artery and minimizes the risk of unforeseen bleeding. Thirty-nine patients underwent robotic right hemicolectomy with this procedure. No intraoperative complications were observed. The median number of dissected lymph nodes was 50, including 16 main lymph nodes. The median operative time was 284 min, blood loss was 50 mL, and the median postoperative hospital stay was 8 days. Postoperative complications included two cases of Clavien–Dindo classification grade II, with no cases of grade III or higher. Chylous leakage as well as intractable diarrhea were not observed in any case. These findings demonstrate that the procedure can achieve safe and reliable lymph node clearance.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"199-204"},"PeriodicalIF":2.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930547","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":"Digestive tract reconstruction after laparoscopic proximal gastrectomy: Double tract reconstruction or double flap technique?","authors":"Lindi Cai,&nbsp;Guanglin Qiu,&nbsp;Mengke Zhu,&nbsp;Shangning Han,&nbsp;Pengwei Zhao,&nbsp;Panxing Wang,&nbsp;Xiaowen Li,&nbsp;Xinhua Liao,&nbsp;Xiangming Che,&nbsp;Lin Fan","doi":"10.1002/ags3.12857","DOIUrl":"10.1002/ags3.12857","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The reconstruction methods after proximal gastrectomy (PG) are varied but not standardized. This study was performed to evaluate the short-term clinical outcomes between double tract reconstruction (DTR) and double flap technique (DFT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed and collected data of patients who underwent DTR and DFT after laparoscopic proximal gastrectomy (LPG), respectively, between January 2020 and March 2023. Propensity score matching (PSM) was used to balance the baseline data of the two groups, then we compared their short-term clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 72 patients (48 and 24 patients in the DTR and DFT groups, respectively) were included. The anastomosis time was significantly longer in the DFT group than that in the DTR group (70.1 vs. 52.7 min, <i>p</i> &lt; 0.001). DFT was associated with shorter times of gas-passing, start of diet, and postoperative length of hospital stay (<i>p</i> &lt; 0.001). There were no significant differences between the two groups in terms of early and late postoperative complications (<i>p</i> = 0.710, <i>p</i> = 1.000, respectively). DFT was superior to DTR in maintaining body weight (<i>p</i> &lt; 0.001), total protein (<i>p</i> = 0.011) and albumin levels (<i>p</i> = 0.018). As for QOL, DTR showed better results in the meal-related distress subscale (<i>p</i> &lt; 0.001). However, DFT was superior to DTR in terms of reducing diarrhea, constipation, and dumping related symptoms (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Double flap technique emerged as a superior alternative to DTR in terms of facilitating early postoperative recovery, sustaining nutritional status, and improving QOL. DFT could potentially be the preferred reconstruction method following laparoscopic proximal gastrectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"98-108"},"PeriodicalIF":2.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930505","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":"Intraluminal washout in rectal and sigmoid colon cancer surgeries with double-stapling technique anastomosis: A single-institution prospective study","authors":"Shinji Furuya,&nbsp;Kensuke Shiraishi,&nbsp;Hiroki Shimizu,&nbsp;Koichi Takiguchi,&nbsp;Makoto Sudo,&nbsp;Akaike Hidenori,&nbsp;Yoshihiko Kawaguchi,&nbsp;Hidetake Amemiya,&nbsp;Tetsuo Kondo,&nbsp;Daisuke Ichikawa","doi":"10.1002/ags3.12851","DOIUrl":"10.1002/ags3.12851","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to determine the necessity of intraluminal washout through cytological assessment to prevent implantation of exfoliated cancer cells (ECCs) in patients with rectal and sigmoid cancers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied 140 patients with either sigmoid or rectal cancer who underwent anastomosis surgery using a double-stapling technique. An intraluminal washout sample was collected before and after irrigation with 1000, 1500, or 2000 mL of physiological saline or distilled water. Cytological assessments were conducted using the Papanicolaou classification system, where classes IV and V indicated positive cytological findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Initially, 46.4% of the patients (65 out of 140) had positive ECCs. Patients with cancer cells had a significantly shorter distal free margin (DM) from the tumor (<i>p</i> &lt; 0.001). The length of the DM was significantly associated with the tumor distance from the anal verge (<i>p</i> &lt; 0.001). After irrigation with 2000 mL, ECCs were found in only 7.3% of patients. Logistic regression analysis showed that DM (≤50 mm) and tumor size (≥50 mm) were independent risk factors for positive ECCs after intraluminal washout, regardless of the type of irrigation solution used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with sigmoid colon cancer, adequate preoperative bowel preparation, a long DM, and a small tumor size, a 1000 mL intraluminal washout may be sufficient. By contrast, in patients with rectal cancer with a short DM and a large tumor size, a ≥2000 mL intraluminal washout is required. The different types of irrigation solution did not affect the ECCs. Large randomized controlled trials are required to confirm these results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"137-144"},"PeriodicalIF":2.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930494","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":"Short-term outcomes of robot-assisted versus conventional minimally invasive esophagectomy: A propensity score-matched study via a nationwide database","authors":"Tatsuto Nishigori,&nbsp;Hiraku Kumamaru,&nbsp;Kazutaka Obama,&nbsp;Koichi Suda,&nbsp;Shigeru Tsunoda,&nbsp;Yukie Yoda,&nbsp;Makoto Hikage,&nbsp;Susumu Shibasaki,&nbsp;Tsuyoshi Tanaka,&nbsp;Masanori Terashima,&nbsp;Yoshihiro Kakeji,&nbsp;Masafumi Inomata,&nbsp;Yuko Kitagawa,&nbsp;Hiroaki Miyata,&nbsp;Yoshiharu Sakai,&nbsp;Hirokazu Noshiro,&nbsp;Ichiro Uyama","doi":"10.1002/ags3.12854","DOIUrl":"10.1002/ags3.12854","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The advantages of robot-assisted minimally invasive esophagectomy (RA-MIE) over conventional minimally invasive esophagectomy (C-MIE) are unknown. This nationwide large-scale study aimed to compare surgical outcomes between RA-MIE and C-MIE using rigorous propensity score methods, including detailed covariates and relevant outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This Japanese nationwide retrospective cohort study included RA-MIE or C-MIE for esophageal malignant tumors performed between October 2018 and December 2019 and registered in the Japanese National Clinical Database. The primary outcome measure was postoperative complications classified as Clavien–Dindo Grade IIIa or higher. Propensity score matching was performed to create a balanced covariate distribution between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After propensity score matching, 1092 patients were selected. The RA-MIE group had a significantly longer operation time and greater blood loss than the C-MIE group (565 vs. 477 min and 120 vs. 90 mL). Furthermore, the R0 resection rate was lower in the RA-MIE group than in the C-MIE group (95.1% vs. 97.8%). The RA-MIE and C-MIE groups had no differences regarding overall complications ≥ Grade IIIa (22.0% vs. 20.3%, <i>p</i> = 0.52), 30-day mortality rates (0.4% vs. 0.5%), and operative mortality rates (0.7% vs. 0.7%). Deep SSI was less frequent (2.7% vs. 6.0%) and pulmonary embolism was more frequent (2.4% vs. 0.5%) in the RA-MIE group than in the C-MIE group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the initial phase of implementation, RA-MIE and C-MIE demonstrated comparable morbidity rates when performed by skilled board-certified endoscopic surgeons.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"109-118"},"PeriodicalIF":2.9,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930573","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 surgical outcomes and postoperative nutritional parameters between subtotal and proximal gastrectomy in patients with proximal early gastric cancer","authors":"Wataru Soneda,&nbsp;Masanori Terashima,&nbsp;Yusuke Koseki,&nbsp;Kenichiro Furukawa,&nbsp;Keiichi Fujiya,&nbsp;Yutaka Tanizawa,&nbsp;Hiroya Takeuchi,&nbsp;Etsuro Bando","doi":"10.1002/ags3.12856","DOIUrl":"10.1002/ags3.12856","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>In this study, we evaluated the difference in short-term outcomes and postoperative nutritional status between subtotal gastrectomy (sTG) and proximal gastrectomy (PG) to determine the optimal surgical treatment for early gastric cancer in the upper third of the stomach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who underwent laparoscopic or robotic sTG or PG at the Shizuoka Cancer Center in Shizuoka between January 2014 and December 2020 were enrolled in this retrospective study. Patient characteristics, surgical outcomes, endoscopic findings, and postoperative nutritional changes, including blood tests, body weight, psoas muscle, and subcutaneous and visceral adipose tissue, were measured and compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 110 patients were enrolled, including 42 in the sTG group and 68 in the PG group. Albumin and hemoglobin levels were comparable between the two groups. Changes in body weight and psoas mass index measured over 36 months postoperatively were favorable in the sTG group compared with the PG group (<i>p</i> = 0.005 and <i>p</i> = 0.002, respectively). There were no significant differences in subcutaneous or visceral adipose tissue between the two groups (<i>p</i> = 0.331 and 0.845, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>sTG is the preferred function-preserving gastrectomy procedure for early gastric cancer in the upper third of the stomach because it is associated with less postoperative body weight loss and psoas mass index loss.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"89-97"},"PeriodicalIF":2.9,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930502","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":"Texture analysis of CT colonography to develop a novel imaging biomarker for the management of colorectal cancer","authors":"Hisashi Mamiya,&nbsp;Toru Tochigi,&nbsp;Koichi Hayano,&nbsp;Gaku Ohira,&nbsp;Shunsuke Imanishi,&nbsp;Tetsuro Maruyama,&nbsp;Yoshihiro Kurata,&nbsp;Yumiko Takahashi,&nbsp;Atsushi Hirata,&nbsp;Hisahiro Matsubara","doi":"10.1002/ags3.12852","DOIUrl":"10.1002/ags3.12852","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recent studies have focused on evaluating the biomarker value of textural features in radiological images. Our study investigated whether or not a texture analysis of computed tomographic colonography (CTC) images could be a novel biomarker for colorectal cancer (CRC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study investigated 263 patients with CRC who underwent contrast-enhanced CTC (CE-CTC) before curative surgery between January 2014 and December 2017. Multiple texture analyses (fractal, histogram, and gray-level co-occurrence matrix [GLCM] texture analyses) were applied to CE-CTC (portal-venous phase), and fractal dimension (FD), skewness, kurtosis, entropy, and GLCM texture parameters, including GLCM-correlation, GLCM-autocorrelation, GLCM-entropy, and GLCM-homogeneity, of the tumor were calculated. These texture parameters were compared with pathological factors (tumor depth, lymph node metastasis, vascular invasion, and lymphatic invasion) and overall survival (OS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tumor depth was significantly associated with FD, kurtosis, entropy, GLCM-correlation, GLCM-autocorrelation, GLCM-entropy, and GLCM-homogeneity (<i>p</i> = 0.001, 0.001, 0.001, 0.001, 0.018, 0.008, and 0.001, respectively); lymph node metastasis was associated with GLCM-homogeneity (<i>p</i> = 0.004); lymphatic invasion was associated with GLCM-correlation and GLCM-homogeneity (<i>p</i> = 0.001 and 0.012, respectively); and venous invasion was associated with FD, entropy, GLCM-correlation, GLCM-autocorrelation, and GLCM-entropy of the tumor (<i>p</i> = 0.001, 0.033, 0.021, 0.046, respectively). In the Kaplan–Meier analysis, patients with high GLCM-correlation tumors or high GLCM-homogeneity tumors showed a significantly worse OS than others (<i>p</i> = 0.001 and 0.04, respectively). Multivariate analyses showed that the GLCM correlation was an independent prognostic factor for the OS (<i>p</i> = 0.021).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CE-CTC-derived texture parameters may be clinically useful biomarkers for managing CRC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"145-152"},"PeriodicalIF":2.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930574","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 obesity on postoperative complications in ulcerative colitis: A systematic review and meta-analysis","authors":"L. M. Tóth,&nbsp;H. Székely,&nbsp;A. Rancz,&nbsp;Á. Zolcsák,&nbsp;M. D. Sárközi,&nbsp;S. Ábrahám,&nbsp;L. Földvári-Nagy,&nbsp;B. Erőss,&nbsp;P. Hegyi,&nbsp;P. Miheller","doi":"10.1002/ags3.12855","DOIUrl":"10.1002/ags3.12855","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prevalence of ulcerative colitis (UC) is around 200/100 000 people. Colectomy is required in 7.5%–40% of patients and 58.8%–94% of these operations are elective. Approximately one in two adults with UC are overweight or obese.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Our aim was to compare postoperative complications between obese (defined by a body mass index (BMI) over 30 kg/m²) and non-obese UC patients who underwent total proctocolectomy with ileal pouch-anal anastomosis (IPAA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our preregistered protocol can be found on PROSPERO (CRD42022377761). We conducted our search in three databases on the 26th of November 2022. PRISMA 2020 guideline and the Cochrane Handbook were applied. We used the GRADEpro program and the QUIPS tool. We applied a random-effects model to pool effect sizes. We included cohort and case–control studies investigating UC patients undergoing colectomy with IPAA and reported information on postoperative complications in obese and non-obese patients. We used mean difference (MD) for continuous variables and calculated odds ratio (OR) with a 95% confidence interval (CI) for dichotomous variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 6870 hits of our systematic search, we included three retrospective cohort studies for analyses involving 4929 patients in our research. Neither the incidence of complications at 30 days after surgery [OR = 1.08; CI: 0.65–1.79] nor the incidence of septic complications [OR = 1.11; CI: 0.85–1.46] had any clinical relevance, except for the length of hospital stay [MD = 0.36; CI:0.04–0.69]. When we assessed the risk of bias, we found that most of the aspects examined had a moderate overall risk. Our results have very low certainty of evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Relevance</h3>\u0000 \u0000 <p>Our findings suggest that obesity defined as BMI over 30 kg/m² may not associated with an increased risk of higher rates of overall postoperative complications compared to non-obese patients. Obesity with a cut-off value of 30 kg/m² does not appear to be a primary reason for prehabilitation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 1","pages":"153-160"},"PeriodicalIF":2.9,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930533","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}