Annals of Gastroenterological Surgery最新文献

{"title":"Current status of total pancreatectomy with islet autotransplantation for chronic and recurrent acute pancreatitis","authors":"Kei Yamane,&nbsp;Takayuki Anazawa,&nbsp;Kazuyuki Nagai,&nbsp;Takashi Ito,&nbsp;Etsuro Hatano","doi":"10.1002/ags3.12767","DOIUrl":"https://doi.org/10.1002/ags3.12767","url":null,"abstract":"<p>Total pancreatectomy with islet autotransplantation (TPIAT) is an established and effective treatment modality for patients diagnosed with intractable chronic pancreatitis (CP) and recurrent acute pancreatitis (RAP). TPIAT primarily aims to manage debilitating pain leading to impaired quality of life among patients with CP or RAP, which can be successfully managed with medical, endoscopic, or surgical interventions. TPIAT is significantly successful in relieving pain associated with CP and improving health-related quality of life outcomes. Furthermore, the complete loss of pancreatic endocrine function attributed to total pancreatectomy (TP) can be compensated by autologous islet transplantation (IAT). Patients receiving IAT can achieve insulin independence or can be less dependent on exogenous insulin compared with those receiving TP alone. Historically, TPIAT has been mainly used in the United States, and its outcomes have been improving due to technological advancements. Despite some challenges, TPIAT can be a promising treatment for patients with CP-related intractable pain. Thus far, TPIAT is not commonly performed in Japan. Nevertheless, it may improve health-related quality of life in Japanese patients with CP, similar to Western patients. This review article aimed to provide an overview of the indications, related procedures, and outcomes of TPIAT and to discuss future prospects in Japan.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 3","pages":"401-412"},"PeriodicalIF":2.7,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12767","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140820685","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 patients at high risk for recurrence in carcinoma of the ampulla of Vater: Analysis in 460 patients","authors":"Masato Narita,&nbsp;Etsuro Hatano,&nbsp;Koji Kitamura,&nbsp;Ken Fukumitsu,&nbsp;Hirohisa Kitagawa,&nbsp;Yuhei Hamaguchi,&nbsp;Takefumi Yazawa,&nbsp;Hiroaki Terajima,&nbsp;Kazuhiko Kitaguchi,&nbsp;Toshihiko Hata,&nbsp;the Kyoto University Hepato-Biliary Pancreatic surgery Study Group (KUHBPS)","doi":"10.1002/ags3.12764","DOIUrl":"https://doi.org/10.1002/ags3.12764","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Carcinoma of the ampulla of Vater (CAV) shows a favorable prognosis compared to that with the other periampullary tumors, while some cases have a poor prognosis. The aims of the present study are to clarify the clinicopathological factors associated with poor recurrence-free survival (RFS) in patients with CAV after curative resection and to validate the usefulness of adjuvant chemotherapy (AC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients</h3>\u0000 \u0000 <p>The study design is a multicenter retrospective cohort study. Patients with CAV who underwent pancreaticoduodenectomy between January 2008 and December 2020 at 26 hospitals were analyzed. The 30 clinicopathological factors were evaluated. A propensity score matching (PSM) was used to compare between patients with and without AC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Finally, 460 patients were analyzed. Median duration of follow-up was 47.2 months. Twenty-one prognostic factors associated with poor RFS were identified by univariate analysis. In multivariate analysis, aged ≥71, tumor diameter ≥12 mm, pT2 or higher stage (pT≥2), portal vein invasion (PV+), venous invasion(V+), and node positive disease (pN+) were independent prognostic factors for poor RFS. Out of 80 patients who received AC, 63 patients were assigned to analysis for PSM. The results showed no beneficial effect of AC on RFS. The preoperative factors potentially predicting pT≥2, V+, and/or N+ were at least one of following; (1) CA19-9 &gt; 37 IU/mL, (2) ulcerative or mixed type appearance, (3) except for well-differentiated tumor, or (4) except for intestinal subtype of histology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Aged ≥71, tumor diameter ≥12 mm, pT≥2, PV+, V+, and pN+ were independent prognostic factors for poor RFS in patients with CAV. An additional therapeutic strategy may be desirable in CAV patients at high risk for recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 2","pages":"190-201"},"PeriodicalIF":2.7,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12764","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140043120","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":"Geriatric prognostic scoring system predicts survival after hepatectomy for elderly patients with liver cancer","authors":"Yoshihiro Sakano,&nbsp;Takehiro Noda,&nbsp;Shogo Kobayashi,&nbsp;Hiroshi Akasaka,&nbsp;Kazuya Kato,&nbsp;Kazuki Sasaki,&nbsp;Yoshifumi Iwagami,&nbsp;Daisaku Yamada,&nbsp;Yoshito Tomimaru,&nbsp;Hidenori Takahashi,&nbsp;Tadafumi Asaoka,&nbsp;Junzo Shimizu,&nbsp;Hiromi Rakugi,&nbsp;Yuichiro Doki,&nbsp;Hidetoshi Eguchi","doi":"10.1002/ags3.12762","DOIUrl":"10.1002/ags3.12762","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The number of elderly patients with liver cancer is increasing with the aging society. The Geriatric Prognostic Scoring System is useful in predicting the postoperative prognosis for elderly patients with gastrointestinal cancer. The aim of the present study was to assess the predictive ability of the geriatric prognostic scoring system for postoperative survival in elderly patients with liver cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eighty-eight patients aged ≥75 years who were treated for primary liver cancer and metastatic liver tumor were retrospectively analyzed. The Geriatric Prognostic Score (GPS) was created by several clinical parameters such as age, sex, type of cancer, stage, performance status, body mass index, and comprehensive geriatric assessment. Each patient was divided into two groups of high-risk to low-risk according to their GPS: ≧30 high-risk group and &lt;30 low-risk. The predictive ability of geriatric prognostic scoring system for postoperative survival was assessed in univariate and multivariate analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 88 patients, 75 were diagnosed as hepatocellular carcinoma and 13 as colorectal liver metastasis. After geriatric prognostic scoring system assessments, 26 patients were diagnosed as high-risk and the remaining 62 as low-risk. The 3-year overall survival rates were 78.5% in the low-risk group and 35.1% in the high-risk group (<i>p</i> &lt; 0.001). The univariate and multivariate analyses of overall survival identified high GPS as an independent significant factor (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We could conclude that the geriatric prognostic scoring system is useful in predicting patients' prognosis after hepatectomy and it can provide helpful information to surgeons for determining treatment strategies for elderly patients with liver cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 3","pages":"498-506"},"PeriodicalIF":2.7,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12762","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138961197","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":"Artificial intelligence and surgery","authors":"Masashi Takeuchi,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12766","DOIUrl":"10.1002/ags3.12766","url":null,"abstract":"&lt;p&gt;Artificial intelligence (AI) has a significant impact on the field of health care, particularly imaging and video analyses. It can considerably support clinical decision-making, including the automatic diagnosis of gastrointestinal cancer during endoscopy and automated detection of pulmonary lesions on computed tomography (CT).&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; In the future, AI may provide innovative solutions that improve surgical efficiency and patient outcomes in the field of surgical procedures. Integrating AI into surgery can potentially redefine the surgical procedures, ushering in a new era of personalized and data-driven healthcare.&lt;/p&gt;&lt;p&gt;The role of AI in preoperative planning is substantial. By analyzing large amounts of medical data, including patient records, imaging findings (e.g., CT and endoscopy), and previous history, AI can help surgeons plan more effective and personalized surgical strategies. For instance, it can predict potential perioperative complications, suggesting optimal surgical approaches, and even simulate surgical outcomes. Furthermore, AI can analyze CT scans to create 3D models of patient anatomy, such as blood vessels, allowing surgeons to plan surgeries with a level of detail that was previously unattainable.&lt;/p&gt;&lt;p&gt;Robotic surgery, one of the most notable applications of AI in surgery, has been a game changer. Compared with the conventional approach, robotic systems such as the da Vinci Surgical System enable surgeons to perform fine and complex procedures with more precision, flexibility, and control. AI enhances these systems by providing real-time analysis and precision in movement and learning from each surgery performed, thereby improving the outcomes over time. In particular, advanced image recognition powered by AI algorithms aids in quickly identifying critical anatomical structures, navigating complicated anatomy more easily, and reducing the risk of developing surgical complications.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; In addition, AI's ability to understand and analyze surgical process facilitates seamless information sharing across the surgical team, contributing to the early detection of complications and ensuring rapid intervention.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Moreover, incorporating AI into surgical robots represents a giant leap forward. These AI algorithm-controlled robotic systems perform complex procedures with unparalleled precision. They are often tailored to adapt to the unique skills of individual surgeons, thereby improving surgical accuracy while minimizing the potential for error. The synergistic cooperation between human surgeons and AI-guided robotic systems represents a new era of cooperative, high-leveled surgery.&lt;/p&gt;&lt;p&gt;AI also plays a pivotal role in overseeing and optimizing patient recovery after surgery. Through the use of sensors and data analysis, AI can foresee potential complications and readmissions before serious problems develop, enabling surgeons to provide timely and targeted interv","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 1","pages":"4-5"},"PeriodicalIF":2.7,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12766","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138995285","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":"Evaluation of the advantage of surgeons certified by the endoscopic surgical skill qualification system participating in laparoscopic low anterior rectal resection","authors":"Naruhiko Sawada,&nbsp;Tomonori Akagi,&nbsp;Manabu Shimomura,&nbsp;Yukitoshi Todate,&nbsp;Kunihiko Nagakari,&nbsp;Hiroaki Takeshita,&nbsp;Satoshi Maruyama,&nbsp;Manabu Takata,&nbsp;Nobuki Ichikawa,&nbsp;Koya Hida,&nbsp;Hiroaki Iijima,&nbsp;Shigeki Yamaguchi,&nbsp;Akinobu Taketomi,&nbsp;Takeshi Naitoh,&nbsp;The EnSSURE Study Group Collaboratives in Japan Society of Laparoscopic Colorectal Surgery.","doi":"10.1002/ags3.12763","DOIUrl":"10.1002/ags3.12763","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A technical qualification system was developed in 2004 by the Japan Society for Endoscopic Surgery. An analysis of the EnSSURE study on 3188 stage II–III rectal cancer patients, which was performed by including the participation of qualified surgeons as assistants and advisers without restricting their participation as operators, revealed that the participation of technically qualified surgeons in surgery improved the technical and oncological safety of laparoscopic rectal resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This secondary retrospective analysis of the EnSSURE study examined the advantage of qualified surgeons participating in laparoscopic low anterior resection (LAR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The outcomes of low anterior resection were compared between groups with and without the participation of surgeons qualified by the Endoscopic Surgical Skill Qualification System (<i>Q</i> and non-<i>Q</i> groups, respectively). We used propensity score matching to generate paired cohorts at a one-to-one ratio. The postoperative complication rate, short-term results (hemorrhage volume, operative time, number of dissected lymph nodes, open conversion rate, intraoperative complication rate, and R0 resection rate), and long-term results (disease-free survival rate, local recurrence rate, and overall survival rate) were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The frequencies of postoperative complications, anastomotic bleeding, and intraperitoneal abscess were significantly lower, the operative time was significantly shorter, the postoperative hospital stay was significantly shorter, and the number of dissected lymph nodes was higher in the <i>Q</i> group. No significant differences were observed in disease-free survival, local recurrence, or overall survival rate rates between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The participation of qualified surgeons in LAR is technically advantageous.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 3","pages":"464-470"},"PeriodicalIF":2.7,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12763","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138971594","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":"Adequate gross resection margin length ensuring pathologically complete resection in gastrectomy for gastric cancer: A systematic review and meta-analysis","authors":"Masaru Hayami,&nbsp;Manabu Ohashi,&nbsp;Nozomi Kurihara,&nbsp;Souya Nunobe","doi":"10.1002/ags3.12761","DOIUrl":"10.1002/ags3.12761","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>A positive resection margin (RM) is associated with poor survival after gastrectomy for gastric cancer (GC). However, the adequate RM length to avoid a positive RM remains controversial. We performed a systematic review to examine the RM length required to avoid a positive RM in gastrectomy for GC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This systematic review involved all relevant articles identified in PubMed, the Cochrane Library, Web of Science, and ClinicalTrials.gov until August 2023. The incidence of a positive RM related to the RM length and the possible incidence of a positive RM estimated from the discrepancy between the gross and pathological RM length were evaluated. The Newcastle–Ottawa Scale was used to quantify study quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen studies involving 8983 patients were analyzed. Investigation of the incidence of a positive RM in relation to the RM length showed that a proximal RM length of 6 cm guaranteed a negative RM in gastrectomy. Analyses of the possible incidence of a positive RM revealed that a negative RM would be guaranteed if the proximal RM length was 6 cm in distal gastrectomy, if the esophageal resection length was 2 cm in total gastrectomy for GC without esophageal invasion and 2.5 cm in total or proximal gastrectomy for GC with esophageal invasion or esophagogastric junction cancer, and if the distal RM length was 4 cm in proximal gastrectomy for early GC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The adequate RM lengths to ensure a pathologically negative RM in each type of gastrectomy for GC were herein suggested.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 2","pages":"202-213"},"PeriodicalIF":2.7,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12761","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138599145","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":"How do we prevent severe intra-abdominal infectious complications following minimally invasive gastrectomy for cancer? The usefulness of a novel marker using computed tomography images (minimum umbilicus–vertebra diameter) and robotic surgery","authors":"Naoshi Kubo,&nbsp;Katsunobu Sakurai,&nbsp;Tsuyoshi Hasegawa,&nbsp;Junya Nishimura,&nbsp;Yasuhito Iseki,&nbsp;Takafumi Nishii,&nbsp;Sadatoshi Shimizu,&nbsp;Toru Inoue,&nbsp;Yukio Nishiguchi,&nbsp;Kiyoshi Maeda","doi":"10.1002/ags3.12760","DOIUrl":"10.1002/ags3.12760","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intra-abdominal infectious complications (IAICs) following minimally invasive gastrectomy (MIG) for cancer sometimes worsen short- and long-term outcomes. In this study, we focused on the minimum umbilicus–vertebra diameter (MUVD) in preoperative computed tomography (CT) images and robotic surgery to prevent severe IAIC occurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A total of 400 patients with gastric cancer who underwent 204 laparoscopic gastrectomy (LG) and 196 robotic gastrectomy (RG) procedures were enrolled in this study. We retrospectively investigated the significance of the MUVD and robotic surgery for preventing severe IAICs following MIG using multivariate and propensity score matching analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The MUVD cutoff value was 84 mm by receiver operating characteristic (ROC) curve using severe IAICs as the end point. The MUVD and visceral fat area (VFA) had significantly higher area under the curve (AUC) than BMI (MUVD vs. BMI, <i>p</i> = 0.032; VFA vs. BMI, <i>p</i> &lt; 0.01). In the multivariate analysis, high MUVD (HR, 9.46; <i>p</i> = 0.026) and laparoscopic surgery (HR, 3.35; <i>p</i> = 0.042) were independent risk factors for severe IAIC occurrence. In the propensity matching analysis between robotic and laparoscopic surgery in the high MUVD group, the RG group tended to have a lower severe IAIC rate than the LG group (0% vs. 9.8%, <i>p</i> = 0.056).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The MUVD was a novel and easy-measuring predictor of severe IAICs following MIG. Robotic surgery should be considered first in patients with gastric cancer having an MUVD value of 84 mm or higher from the perspective of severe IAIC occurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 3","pages":"420-430"},"PeriodicalIF":2.7,"publicationDate":"2023-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12760","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138605821","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":"Author's reply: COVID-19 vaccine in liver transplant recipients","authors":"Atsuyoshi Mita,&nbsp;Yasunari Ohno,&nbsp;Yuji Soejima","doi":"10.1002/ags3.12752","DOIUrl":"https://doi.org/10.1002/ags3.12752","url":null,"abstract":"&lt;p&gt;We gratefully acknowledge Drs. Daungsupawong and Wiwanitkit's insights regarding our recently published article “Antibody titer after administration of mRNA-based vaccine against severe acute respiratory syndrome coronavirus 2 in liver transplant recipients.”&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; We reported that mRNA vaccines induce similar humoral responses and decay rates of acquired antibodies in liver-transplant recipients as in healthy individuals.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Accordingly, we deduced that liver-transplant recipients should receive booster vaccination. Although we agree with the majority of the authors' points, we would like to address some of their concerns that were expressed in their Letter to the Editor.&lt;/p&gt;&lt;p&gt;In Japan, as the local government has provided free vaccination against the coronavirus disease (COVID-19), liver-transplant recipients have good access to healthcare. Adults were eligible for vaccination throughout, and children could receive vaccination midway through, the study period. Based on the study's results, liver-transplant recipients received regular vaccinations, and continued to receive booster vaccinations (given every 6 months after the second vaccination) even after the study ended. The average observation period for target patients after the second vaccination was 328 ± 64 days in the study.&lt;/p&gt;&lt;p&gt;With regard to the pre-vaccination history of infections, the impact was likely small, as only two recipients tested positive for anti-nucleocapsid antibodies at the first measurement. Although, data on current infection rates are unavailable, no recipient has developed severe pneumonia in the 1 year since study completion. In the statistics reported by the Japan Society for Transplantation on COVID-19 cases up to August 31, 2022,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; only 237 recipients, including those from our facility, were infected, which is a relatively low incidence. This is largely attributable to nonpharmaceutical preventive interventions, including the behavioral changes of liver-transplant recipients who refrained from venturing out during the COVID-19 pandemic. The infection rate could increase henceforth.&lt;/p&gt;&lt;p&gt;To investigate the protection conferred by neutralizing antibodies against infection, the antibody titer needs frequent measurement to determine the level necessary to prevent infection. However, this is not feasible in clinical practice. As COVID-19 is not a seasonal illness, perennial prevention is essential. Considering the decay rate of neutralizing antibodies, annual booster vaccination seems insufficient to provide preventive immunity. However, with the increased number of individuals with a history of COVID-19 in the community currently, the risk of cluster outbreaks has decreased. Therefore, with regard to vaccination, a multi-societal perspective, which includes infection severity, is needed. As there is an uncertain trend in SARS-CoV-2 infection rates in liver-transplant recipients, continuing booster","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 2","pages":"367-368"},"PeriodicalIF":2.7,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12752","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140043046","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 the COVID-19 pandemic on short-term postoperative outcomes for colorectal perforation: A nationwide study in Japan 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;Yuko Kitagawa,&nbsp;Taizo Hibi,&nbsp;Akinobu Taketomi,&nbsp;Norihiko Ikeda,&nbsp;Masaki Mori","doi":"10.1002/ags3.12758","DOIUrl":"10.1002/ags3.12758","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Possible negative effects of the COVID-19 pandemic on short-term postoperative outcomes for colorectal perforation in Japan were examined in this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The National Clinical Database (NCD) is a large-scale database including more than 95% of surgical cases in Japan. We analyzed 13 107 cases of colorectal perforation from 2019 to 2021. National data were analyzed, and subgroup analyses were conducted for subjects in prefectures with high infection levels (HILs) and metropolitan areas (Tokyo Met. and Osaka Pref.). Postoperative 30-day mortality, surgical mortality, and postoperative complications (Clavien–Dindo grade ≥3) were examined. 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) does not contain 1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the NCD, postoperative 30-day mortality occurred in 1371 subjects (10.5%), surgical mortality in 1805 (13.8%), and postoperative complications in 3950 (30.1%). Significantly higher SMRs were found for 30-day mortality in November 2020 (14.6%, 1.39 [95% CI: 1.04–1.83]) and February 2021 (14.6%, 1.48 [95% CI: 1.10–1.96]), and for postoperative complications in June 2020 (37.3%, 1.28 [95% CI: 1.08–1.52]) and November 2020 (36.4%, 1.21 [95% CI: 1.01–1.44]). The SMRs for surgical mortality were not significantly high in any month. In prefectures with HILs and large metropolitan areas, there were few months with significantly higher SMRs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The COVID-19 pandemic had limited negative effects on postoperative outcomes in patients with colorectal perforation. These findings suggest that the emergency system for colorectal perforation in Japan was generally maintained during the pandemic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 3","pages":"450-463"},"PeriodicalIF":2.7,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12758","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139244136","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":"Key nodal stations for predicting splenic hilar nodal metastasis in upper advanced gastric cancer without invasion of the greater curvature","authors":"Masashi Nishino,&nbsp;Takaki Yoshikawa,&nbsp;Masahiro Yura,&nbsp;Rei Ogawa,&nbsp;Ryota Sakon,&nbsp;Kenichi Ishizu,&nbsp;Takeyuki Wada,&nbsp;Tsutomu Hayashi,&nbsp;Yukinori Yamagata","doi":"10.1002/ags3.12759","DOIUrl":"10.1002/ags3.12759","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Standard surgery for upper advanced gastric cancer without invasion of the greater curvature (UGC-GC) is spleen-preserving D2 total gastrectomy without dissection of the splenic-hilar nodes (#10). However, some patients with nodal metastasis to #10 survive more than 5 years due to nodal dissection of #10. If nodal metastasis to #10 is predictable based on the positivity of other nodes dissected by the current standard surgery without #10 nodal dissection, physicians may be able to consider #10 dissection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study retrospectively reviewed data from the National Cancer Center Hospital in Japan between 2000 and 2012. We selected cases that met the following criteria: (1) D2 or more total gastrectomy with splenectomy, (2) UGC-GC, and (3) histological type is gastric adenocarcinoma. We performed univariate and multivariate analyses concerning lymph node stations associated with #10 metastasis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 366 patients were examined. A multivariate analysis revealed that #10 metastasis was associated with positivity of the nodes along the short gastric arteries (#4sa) and distal nodes along the splenic artery (#11d) (#4sa: <i>p</i> = 0.003, #11d: <i>p</i> = 0.016). When either key node was positive, the metastatic rate of #10 was 24.4%, and the therapeutic value index was 13.3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>#4sa and #11d were key lymph nodes predicting #10 nodal metastasis in UGC-GC. When these key nodes are positive on computed tomography before surgery or according to a rapid pathological examination during surgery, dissection of #10 should be considered even if upper advanced tumors are not invading the greater curvature.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 3","pages":"413-419"},"PeriodicalIF":2.7,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139246552","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}