Publications by authors named "Emiko Kono"

Introduction: Female surgeons have ergonomic issues with commercialized instruments tailored for male surgeons. The purpose of this study was to identify satisfaction levels and ergonomic problems of female surgeons while using laparoscopic forceps with ring-handles and suggest improvement measures.

Material And Methods: A questionnaire was sent to 19,405 members of the Japanese Society of Gastroenterological Surgery email between 1 August 2022 and 30 September 2022.

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Objective: To compare short term surgical outcomes between male and female gastrointestinal surgeons in Japan.

Design: Retrospective cohort study.

Setting: Data from the Japanese National Clinical Database (includes data on >95% of surgeries performed in Japan) (2013-17) and the Japanese Society of Gastroenterological Surgery.

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Article Synopsis
  • Women in Japan face significant underrepresentation in surgical leadership, which is attributed to a lack of equal surgical training opportunities, although this has not yet been thoroughly investigated.
  • A study examined gender disparities in surgical experiences among gastroenterological surgeons, analyzing data from over 1.1 million surgical procedures performed between 2013 and 2017.
  • Results revealed that female surgeons conducted only 7.27% of all operations, with significant gender disparities in experience levels across various surgical procedures, where male surgeons performed considerably more operations compared to their female counterparts.
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Background: Neuroendocrine cell carcinomas (NEC) of the colon and rectum are uncommon, representing ~ 0.1% of all colorectal carcinomas. They are associated with a much worse prognosis compared to adenocarcinoma of the colon and rectum, as death occurs in approximately half of all patients within 1 year.

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Purpose: The concept of 'diversity and inclusion' is being adopted worldwide, but it is not yet understood well in Japan. We conducted this study to evaluate the impact of a lecture aimed at increasing awareness of academic careers and the benefits of having diversity and inclusion.

Methods: Two female surgeons delivered a 120-min lecture on "diversity and inclusion" to third-year medical students at Tokushima University.

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Commercially available laparoscopic instruments are not designed for female surgeons. We redesigned the endoscopic flexible head purse-string suture instrument for improved use by female surgeons. The weight, total length, and diameter of the swing head handle and clump handle were reduced (786 to 565 g, 715 to 700 mm, 70 to 50 mm, and 30 to 25 mm, respectively).

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Article Synopsis
  • The study investigates blood glucose (BG) variability in hemodialysis patients with type 2 diabetes and the effects of DPP-4 inhibitors using continuous glucose monitoring (CGM).
  • It compares BG profiles between patients taking DPP-4 inhibitors and those not, using a linear mixed-effects model for analysis.
  • Results indicate that DPP-4 inhibitors help stabilize BG levels during hemodialysis and reduce the risk of nocturnal hypoglycemia.
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Background: McKittrick-Wheelock syndrome (MKWS) is caused by a villous tumor of the rectosigmoid colon with hypersecretion of mucus containing electrolytes. Complete resection of the tumor is needed to cure this disease. Transanal total mesorectal excision (TaTME) is currently a promising treatment for lower rectal tumor because of the reliability of its resection margin especially in bulky tumor.

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Local recurrence rates of rectal cancer after anterior resection remain high, despite the continued efforts of surgeons to devise preventive measures. Anastomotic recurrence, a form of local recurrence, may be caused by the implantation of exfoliated cancer cells during resection, and rectal stump washout has been proposed as a way to reduce the risk of this occurring. In this review article, we explore the mechanism of anastomotic recurrence after low anterior resection for rectal cancer, and examine the history and effectiveness of rectal washout on reducing recurrence rates, with a focus on washout solutions, procedures, and devices.

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The aim of this study was to evaluate the utility of immediate repair of a contralateral occult hernia at the same time as incipient hernia repair. A total of 693 patients were diagnosed preoperatively with a unilateral groin hernia from January 2006 to December 2017. The open technique was used for 541 patients, and the laparo-endoscopic technique was used for 152 patients.

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A 78-year-old man who developed metastatic liver and lung cancer after undergoing surgery for rectal and sigmoid colon cancer was treated with TAS-102 as fourth-line chemotherapy. He developed high fever and dyspnea and was referred to the emergency room 16 days after receiving the first course of TAS-102. Chest X-ray and computed tomography examinations showed bacterial pneumonia.

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Article Synopsis
  • A 66-year-old woman was diagnosed with advanced esophageal cancer (stage III) and had significant lymph node spread in her body.
  • She underwent two rounds of a chemotherapy regimen called DCF, which showed promising results by significantly reducing the tumor and affected lymph nodes.
  • After surgery, analysis revealed no residual cancer cells, indicating a complete pathological response to the treatment, suggesting DCF chemotherapy may be very effective for this condition.
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Gastric cancer with portal tumor embolus is rare and there is no definite strategy for its surgical resection. We report 2 cases ofgastric cancer with portal vein tumor embolus treated using gastrectomy and thrombectomy. Case 1: The patient was a 56- year-old man.

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Background: The Oxford classification of IgA nephropathy consists of four markers as prognosticators. We retrospectively examined the relevance of extracapillary proliferation involving cellular and fibrocellular crescents (Ex) and arteriolar hyalinosis (A) on the long-term outcome of renal function.

Methods: A total of 314 Japanese patients who were diagnosed with IgA nephropathy, with 12 months or more of follow-up period were included in this study.

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Background: The clinical benefit of cetuximab combined with oxaliplatin-based chemotherapy remains under debate. The aim of the present multicenter open-label Phase II study was to explore the efficacy and safety of biweekly administration of cetuximab and mFOLFOX-6 or XELOX as first-line chemotherapy in patients with metastatic colorectal cancer.

Methods: Sixty-two patients with previously untreated KRAS/BRAF wild-type metastatic colorectal cancer were recruited to the study between April 2010 and May 2011.

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Introduction: Widespread application of laparoscopic cholecystectomy (LC) has resulted in a high complication rate and leads to prolonged hospital stays. This study aimed to investigate the preoperative and intraoperative clinical factors that relate to prolongation of hospital stay.

Methods: We studied 370 patients who underwent LC for gallbladder disease between 2008 and 2012.

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We report 2 cases of resectable advanced gastric cancer who achieved pathological complete response by preoperative chemotherapy with S-1 plus weekly low-dose cisplatin (CDDP). S-1 (80 mg/m²)was administered consecutively for 21 days followed by 14 days' rest, with CDDP (25mg/m²) injected on days 1, 8, and 21. Case 1: A man in his 70s diagnosed with cStage III gastric cancer with lymph node metastases received 2 courses of preoperative chemotherapy with S-1 plus weekly low-dose CDDP followed by total gastrectomy with D2 lymph node dissection.

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Purpose: The satisfaction rating of currently available mechanical staplers for Japanese surgeons with small hands is low. To identify the issue, we examined the relationship of hand dimensions and grip force with the operation force of a mechanical circular stapler.

Methods: Hand dimensions and grip force were measured in 113 Japanese surgeons (52 men and 61 women).

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Purpose: Commercially available mechanical devices for gastrointestinal anastomosis are mostly made in overseas. Japanese female surgeons have described these devices as being too large and difficult to handle. This study investigated the degree of satisfaction and problems experienced by Japanese surgeons in using various staplers for mechanical anastomosis.

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