Annals of Surgical Treatment and Research最新文献

{"title":"Surgical treatment for intractable cholangitis with intrahepatic biliary cysts followed by Kasai operation in biliary atresia: a retrospective cohort study.","authors":"Yu Jeong Cho, Hyunhee Kwon, Yong Jae Kwon, Suhyeon Ha, Seong Chul Kim, Dae Yeon Kim, Jung-Man Namgoong","doi":"10.4174/astr.2024.107.6.363","DOIUrl":"10.4174/astr.2024.107.6.363","url":null,"abstract":"<p><strong>Purpose: </strong>Intrahepatic biliary cysts (IBCs) after Kasai portoenterostomy (KPE) are associated with intractable recurrent cholangitis. This study aimed to investigate the feasibility of its use as well as indication for surgical management of IBCs in pediatric patients.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records and imaging studies of patients who underwent KPE for biliary atresia from 2010 to 2020.</p><p><strong>Results: </strong>An imaging study identified IBCs in 28 of 129 patients who underwent KPE with biliary atresia (21.7%). Among them, 5 patients were subjected to surgical treatment for intractable cholangitis. The median time from KPE to the development of IBCs was 1.7 years. Four out of 5 patients had IBCs confined to the left lateral lobe, and in one patient, the IBCs were in the hepatic hilum. All 5 patients experienced more than one cholangitis. Although they received intravenous antibiotic treatment and percutaneous transhepatic cholangiodrainage as treatment, they were intractable. Three patients underwent hepatectomy, and 2 underwent cystojejunostomy. There was no recurrence of cholangitis during the median follow-up period of 2.9 years.</p><p><strong>Conclusion: </strong>Surgical treatment for IBCs after KPE could be considered a safe and effective surgical procedure for children if appropriate indications are applied.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"363-368"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816830","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 the postoperative complications for gastric cancer surgery before and during the medical crisis in South Korea: a retrospective observational study.","authors":"Kyoungdong Lee, Ba Ool Seong, Moon-Won Yoo","doi":"10.4174/astr.2024.107.6.354","DOIUrl":"10.4174/astr.2024.107.6.354","url":null,"abstract":"<p><strong>Purpose: </strong>In 2024, South Korea experienced a substantial shortage of medical practitioners, primarily residents and interns, owing to mass resignation from training hospitals. This study aimed to evaluate whether the quality of medical care declined because of this shortage by comparing postoperative complications before and during the period of mass resignation.</p><p><strong>Methods: </strong>This retrospective observational study assessed patient outcomes among patients with gastric cancer before and during a period of mass resignation at a single tertiary training hospital. Outcomes analyzed included operation duration, length of hospital stays, and complication rates. The effects of the medical crisis on complication rates were analyzed using logistic regression.</p><p><strong>Results: </strong>A total of 218 and 31 patients underwent surgery during the control and crisis periods, respectively. During the control period, approximately 73 surgeries were performed between February 20 and June 10 each year, which was reduced to 31 during the crisis period. The operation duration (minutes) was 164.5 before the medical crisis and 154.0 during it (P = 0.19). The incidence of postoperative complications before and during the medical crisis was 22.02% (48 of 218) and 9.68% (3 of 31), respectively (P = 0.15). No severe complications (Clavien-Dindo grade ≥IIIa) were observed during the crisis period. Multivariate logistic regression revealed that sex and body mass index were significant variables associated with postoperative complications, but the effects of medical crisis were not.</p><p><strong>Conclusion: </strong>Despite the medical crisis in South Korea, patient outcomes for gastric cancer surgery were sustained in terms of the frequency of postoperative complications.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"354-362"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816907","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":"Development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program: a nationwide project to improve surgical quality and patient safety.","authors":"Jeong-Moo Lee, In Woong Han, Oh Chul Kwon, Hye Rim Seo, Jipmin Jung, So Jeong Yoon, Ahram Han, Juhan Lee, Soo Young Lee, Hoseok Seo, Wooil Kwon, Bang Wool Eom, In-Seob Lee, Ji Won Park, Hae Won Lee, Ho Kyoung Hwang, Suk-Hwan Lee, Eung Jin Shin, Woo Yong Lee","doi":"10.4174/astr.2024.107.6.305","DOIUrl":"10.4174/astr.2024.107.6.305","url":null,"abstract":"<p><strong>Purpose: </strong>Improvements in surgical quality and patient safety are critical components of the healthcare system. Despite excellent cancer survival rates in Korea, there is a lack of standardized postoperative complication management systems. To address this gap, the Korean Surgical Society initiated the development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program.</p><p><strong>Methods: </strong>K-QIPS was successfully launched in 87 general hospitals. This nationwide surgical quality improvement program covers 5 major surgical fields: gastric surgery, colorectal surgery, hepatectomy and liver transplantation, pancreatectomy, and kidney transplantation.</p><p><strong>Results: </strong>Common and surgery-specific complication platforms will be developed, and the program will work toward the implementation of an artificial intelligence-based complication prediction system and the provision of evidence-based feedback to participating institutions. K-QIPS represents a significant step toward improving surgical quality and patient safety in Korea.</p><p><strong>Conclusion: </strong>This program aims to reduce postoperative complications, mortality, and medical costs by providing a standardized platform for complication management and prediction. The successful implementation of this nationwide project may provide a good model for other countries that are required to improve surgical outcomes and patient care.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"305-314"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816873","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":"Validation of the Vascular Study Group of New England (VSGNE) risk prediction model for abdominal aortic aneurysm repair in Korea: a single-center retrospective study.","authors":"Hyo-Shin Kim, Da-Hyun Kim, Dong-Ik Kim, Joon-Kee Park, Shin-Seok Yang, Yang-Jin Park","doi":"10.4174/astr.2024.107.6.315","DOIUrl":"10.4174/astr.2024.107.6.315","url":null,"abstract":"<p><strong>Purpose: </strong>The Vascular Study Group of New England (VSGNE) risk prediction model is a simple method for estimating risk for elective abdominal aortic aneurysm (AAA) repair. The model considers both treatment methods and the physical characteristics of the aneurysm type as well as comorbidities. This research aimed to validate its effectiveness by analyzing retrospective data on Korean patients.</p><p><strong>Methods: </strong>Our single-center retrospective analysis included 1,227 patients who underwent elective open repair surgery (ORS) or endovascular aortic repair (EVAR) from 2005 to 2021. We assessed the discrimination of the risk score and the effects of several risk factors.</p><p><strong>Results: </strong>Most patients (66.7%) were classified as low risk in the model, with only 5.6% considered high risk. The mean risk score was 2.81, significantly lower than reported in previous studies. The actual 30-day mortality was only 0.7%, less than the predicted 1.1%. The accuracy of the model in predicting 30-day mortality was statistically significant (area under the curve, 0.822). Patients with high scores were associated with significantly increased mortality (odds ratio, 3.9; P < 0.001). Factors such as advanced age, cerebrovascular disease, and elevated creatinine levels were influential in mortality outcomes. However, a significant difference was not found in short-term mortality between ORS and EVAR.</p><p><strong>Conclusion: </strong>Although the VSGNE model is an objective tool for assessing death risk in elective AAA repair, the actual risk scores in our patient population were lower than predicted. To create a more representative tool for the Korean population, we suggest developing a novel model based on multicenter data collection.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"315-326"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816890","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 implications of ductal carcinoma <i>in situ</i> components in <i>BRCA1/2</i>-positive breast cancer: a retrospective cohort study.","authors":"Kyung-Hwak Yoon, Eun-Kyu Kim, Hee-Chul Shin","doi":"10.4174/astr.2024.107.6.327","DOIUrl":"10.4174/astr.2024.107.6.327","url":null,"abstract":"<p><strong>Purpose: </strong>Although the breast cancer susceptibility gene <i>(BRCA)</i>-associated invasive breast cancer is well studied, there are limited reports on ductal carcinoma <i>in situ</i> (DCIS) in patients with <i>BRCA1/2</i> mutations. This study aims to evaluate the differential prognostic effect of DCIS in breast cancer patients with pathologic variants of <i>BRCA1/2</i> genes.</p><p><strong>Methods: </strong>Breast cancer patients who tested positive for <i>BRCA1/2</i> mutations between August 2003 and January 2022 at a single tertiary referral center were retrospectively analyzed. Survival outcomes were compared between patients with both invasive ductal carcinoma (IDC) and DCIS (IDC-DCIS group, n = 121) and those with IDC alone (IDC group, n = 36).</p><p><strong>Results: </strong>Of the 157 patients, 65 (41.4%) exhibited mutations in <i>BRCA1</i>, 90 (57.3%) in <i>BRCA2</i>, and 2 (1.3%) in both <i>BRCA1/2</i>. DCIS components were more frequently found in <i>BRCA2</i> pathological variants (<i>BRCA1</i>, 46 [38.0%] <i>vs.</i> <i>BRCA2</i>, 76 [62.4%]; P = 0.030). No statistically significant difference was found in 10-year recurrence-free survival (IDC-DCIS, 89.3% <i>vs.</i> IDC, 83.6%; P = 0.989). Subgroup analysis indicated that the DCIS component correlated with improved survival outcomes in the <i>BRCA1</i> subgroup (<i>BRCA1</i> IDC-DCIS, 85.5% <i>vs.</i> <i>BRCA1</i> IDC, 51.0%; P = 0.024). Conversely, in the <i>BRCA2</i> subgroup, IDC-DCIS patients exhibited a worse prognosis (<i>BRCA1</i> IDC-DCIS, 85.5% <i>vs.</i> <i>BRCA2</i> IDC-DCIS, 65.8%; P = 0.045).</p><p><strong>Conclusion: </strong>The presence of a DCIS component carries varied prognostic significance in <i>BRCA1</i> and <i>BRCA2</i> mutations. A tailored approach may be necessary when determining treatment options for breast cancer patients with <i>BRCA1/2</i> mutations based on the presence of DCIS.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 6","pages":"327-335"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816827","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":"Mortality and associated factors among patients who underwent liver transplantation in South Korea from 2017 to 2021: a retrospective observational study.","authors":"Tak Kyu Oh, In-Ae Song","doi":"10.4174/astr.2024.107.5.245","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.245","url":null,"abstract":"<p><strong>Purpose: </strong>Liver transplantation (LT) in South Korea dates back to 1988. However, Asians may be reluctant to donate their organs because of the influence of their traditional religious and philosophical beliefs. We aimed to investigate the mortality and associated factors among patients admitted after LT in South Korea.</p><p><strong>Methods: </strong>The South Korean National Health Insurance Service database was used as a data source. All adult patients who underwent LT between January 1, 2017 and December 31, 2021 (5 years) were included in the study.</p><p><strong>Results: </strong>A total of 7,316 patients were included in the analysis (living donor LT [LDLT], 5,412; deceased donor LT [DDLT], 1,904). The 1-year mortality rate was 12.8% (LDLT, 8.2%; DDLT, 25.9%; P < 0.001), and the postoperative complication rate was 26.8% (LDLT, 16.7%; DDLT, 55.6%; P < 0.001). The average length of hospital stay was 30.8 days, and that in the intensive care unit was 6.1 days. The total mean cost was 69,954 US dollars, and the self-cost was 6,008 US dollars. After adjusting confounders, DDLT (hazard ratio [HR], 2.10; 95% confidence interval [CI], 1.79-5.20; P < 0.001), re-LDLT (HR, 4.82; 95% CI, 3.10-7.40; P < 0.001), re-DDLT (HR, 4.65; 95% CI, 3.55-7.12; P < 0.001), and postoperative complications (HR, 1.72; 95% CI, 1.39-2.12; P < 0.001) were potential risk factors for higher 1-year mortality after transplantation.</p><p><strong>Conclusion: </strong>LDLT was performed at a higher rate in South Korea and was associated with lower mortality and fewer postoperative complications than DDLT. Redo LT led to higher mortality rates.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"245-251"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613595","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":"Knowledge of energy-based devices among surgical residents: a cross-sectional study.","authors":"Can Uc, Yigit Turk, Pınar Uc, Recep Temel, Murat Ozdemır, Ozer Makay","doi":"10.4174/astr.2024.107.5.300","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.300","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the knowledge of surgical residents in a tertiary hospital regarding the operational principles, potential complications, and mechanisms of energy devices used in surgery.</p><p><strong>Methods: </strong>A 16-question test was developed using educational materials in the \"Fundamental Use of Surgical Energy (FUSE)\" program, prepared by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) for educational purposes, and from literature on energy devices. The test was shared online with surgical branch residents via Google Forms, and they were asked to complete it. Participants were given one week to complete the test and return the results online.</p><p><strong>Results: </strong>A total of 108 residents voluntarily participated in the study. The average number of correct answers was 6.5 out of 16. There was no significant difference between the correct answer rates for surgical branches. However, an increase in surgical seniority was associated with a higher number of correct answers (P < 0.001).</p><p><strong>Conclusion: </strong>Theoretical education about energy devices in surgical training needs to be improved. Surgical residents reported insufficient knowledge regarding the devices' operational principles and complication mechanisms.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"300-304"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635875","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":"Effectiveness and safety of chlorhexidine gluconate double-cleansing for surgical site infection prevention in neonatal intensive care unit surgical patients.","authors":"Jin Ah Kwon, Min Jeng Cho","doi":"10.4174/astr.2024.107.5.291","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.291","url":null,"abstract":"<p><strong>Purpose: </strong>This study assessed the efficacy and safety of preoperative chlorhexidine gluconate (CHG) double-cleansing in reducing the incidence of surgical site infections (SSI) in surgical patients in neonatal intensive care units.</p><p><strong>Methods: </strong>A retrospective chart review involved 56 patients who underwent 73 surgical procedures in the neonatal intensive care unit (NICU) from 2013 to 2022. CHG double-cleansing involves the following 2 processes. Firstly, preoperative cleansing with 0.5% CHG for elective surgeries the night before or at least 1 hour before emergency surgery. The anterior trunk cleansing spanned from the neck to the pubis, including both axillary lines. Secondly, the surgical site underwent skin preparation using 2% CHG with 72% isopropyl alcohol before an incision. A control group (2013-2018) that used iodine and a CHG group (2019-2022) employing CHG double-cleansing were compared. The occurrence of SSIs within 30 days after the surgical procedure was assessed.</p><p><strong>Results: </strong>The overall SSI rate was 16.4% (n = 12) in the total procedures. The SSI rate was significantly higher (22.6%) in the control group; no SSI occurred in the CHG group (P = 0.029). No significant differences were observed in the other parameters. No adverse effects were observed in the CHG group.</p><p><strong>Conclusion: </strong>CHG double-cleansing, a modified approach for surgical patients in the NICU, effectively reduced the incidence of SSI compared to traditional iodine-based skin preparations. This study supports the safe use of CHG in neonates, including premature infants, without significant complications.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"291-299"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613541","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":"Primary tumor sidedness is not prognostic factor in resectable colorectal cancer liver metastasis: a retrospective observational cohort study.","authors":"Sung Jun Jo, Jongman Kim, Jung Kyong Shin, Jinsoo Rhu, Jung Wook Huh, Gyu-Seong Choi, Jae-Won Joh","doi":"10.4174/astr.2024.107.5.264","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.264","url":null,"abstract":"<p><strong>Purpose: </strong>Right-sided tumors have been reported to have a poorer survival rate than left-sided tumors; however, there remains debate regarding whether sidedness is an independent prognostic factor in colorectal cancer liver metastasis (CRLM). This study aimed to assess the impact of sidedness on prognosis in resectable CRLM and to identify prognostic factors.</p><p><strong>Methods: </strong>Patients who underwent liver resection for CRLM at Samsung Medical Center from January 2008 to December 2021 were included in the investigation. Overall survival (OS) and progression-free survival (PFS) were analyzed, and prognostic factors were identified.</p><p><strong>Results: </strong>A total of 497 patients were included in the study, with 106 on the right side and 391 on the left side. The right-sided group had a higher percentage of synchronous tumors (90.6% <i>vs.</i> 80.3%, P = 0.020). In survival analysis, the right side showed lower 5-year OS (49.7% <i>vs.</i> 54.2, P = 0.305) and 5-year PFS (57.1% <i>vs.</i> 60.2%, P = 0.271), but the differences were not statistically significant. In the analysis of prognostic factors, synchronous tumor (odds ratio [OR], 5.01; P < 0.001), CEA (OR, 1.46; P = 0.016), and maximum tumor size of hepatic metastasis (OR, 1.09; P = 0.026) were associated with OS.</p><p><strong>Conclusion: </strong>In resectable CRLM, there was no difference in prognosis based on sidedness. CEA level, synchronous tumor, and maximum tumor size of hepatic metastasis were identified as prognostic factors.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"264-273"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613660","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":"The efficacy of exosomes from human chemically derived hepatic progenitors in liver damage alleviation: a preclinical experimental study.","authors":"Min Kim, Tae Hun Kim, Elsy Soraya Silva Salas, Soyoung Jeon, Ji Hyun Shin, Dongho Choi","doi":"10.4174/astr.2024.107.5.252","DOIUrl":"https://doi.org/10.4174/astr.2024.107.5.252","url":null,"abstract":"<p><strong>Purpose: </strong>Over the past decade, interest in exosomes as therapeutics has surged. In particular, stem-cell-derived exosomes may be more effective as a treatment for liver disease than the stem cells themselves. We have previously developed human chemically derived hepatic progenitors (hCdHs) from human hepatocytes. hCdHs can differentiate into hepatocytes and cholangiocytes, regenerating the liver in mouse models. In this study, we evaluated the mitigating effects of hCdHs-derived exosomes (hCdHs-exo) on liver damage and compared them with those of exosomes from bone marrow mesenchymal stem cells (BMMSCs-exo).</p><p><strong>Methods: </strong>Exosomes were isolated from hCdHs and BMMSCs by culturing cells in large quantities and separating the exosomes from the culture medium using ultracentrifugation. Isolated exosomes were characterized by various methods before experimental use. <i>In vitro</i>, the ability of exosomes to inhibit activation of hepatic stellate cells (HSCs) by transforming growth factor beta 1 was evaluated. <i>In vivo</i>, exosomes were injected into mice with carbon tetrachloride (CCl₄)-induced liver damage, and their effectiveness in mitigating liver damage was assessed by histological staining and biochemical analysis.</p><p><strong>Results: </strong>The analyses confirmed the successful isolation of exosomes from both cell types. <i>In vitro</i>, hCdHs-exo significantly reduced the levels of transcription factors and activation markers in induced HSCs. <i>In vivo</i>, hCdHs-exo effectively alleviated liver damage caused by CCl₄. Furthermore, both <i>in vitro</i> and <i>in vivo</i> studies confirmed that hCdHs-exo had a greater effect in alleviating liver damage than did BMMSCs-exo.</p><p><strong>Conclusion: </strong>These results demonstrate that hCdHs-exo, similarly to hCdHs, have superior efficacy in alleviating liver damage compared with BMMSCs-exo.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"107 5","pages":"252-263"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613663","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}