Publications by authors named "Hiromitsu Maehira"
Background: The wound healing effects of a specialized amino acid supplement containing calcium beta-hydroxy-beta-methylbutyrate, L-arginine, and L-glutamine (HMB/Arg/Gln) have been reported. This study aimed to investigate the effectiveness of HMB/Arg/Gln in the perioperative management of patients with thoracic esophageal cancer.
Methods: This retrospective cohort study included 131 patients who underwent esophagectomy for thoracic esophageal cancer between January 2016 and November 2023.
Background: Adjuvant chemotherapy is a standard therapeutic option for resected pancreatic cancer. However, the risk factors for incompletion of adjuvant chemotherapy remain unclear.
Methods: We retrospectively reviewed the medical records of 72 patients who underwent radical pancreatectomy and received S-1 adjuvant chemotherapy for pancreatic cancer.
Article Synopsis
- The study investigates the role of tumor-infiltrating lymphocytes (TILs) in pancreatic ductal adenocarcinoma (PDAC) and how the Immunoscore (IS) relates to patient prognosis after surgery.
- An analysis of tissue samples from 131 PDAC patients showed that a high IS at both the core and invasive margin of tumors was linked to better overall and relapse-free survival.
- The findings suggest that the IS could serve as a valuable prognostic marker for survival and recurrence in PDAC patients, particularly those who have undergone preoperative chemotherapy.
Article Synopsis
- A 73-year-old woman presented with a 40x30 mm tumor in the pancreatic tail, which was found through a CT scan and showed characteristics similar to pancreatic cancer.
- A biopsy confirmed the tumor was metastatic, matching the previous kidney tumor, and the patient underwent surgery to remove it, highlighting the difficulties in monitoring long-term metastasis.
Is multidisciplinary treatment effective for invasive intraductal papillary mucinous carcinoma?
Ann Gastroenterol Surg
September 2024
Article Synopsis
- * Analyzing data from 1183 patients, it found that completing 6 months of postoperative adjuvant therapy significantly improved overall, disease-specific, and recurrence-free survival, especially for high-risk patients.
- * Additionally, neoadjuvant therapy showed benefits for those with borderline resectable IPMC, and any treatment for recurrence after surgery was linked to longer survival compared to no treatment.
Article Synopsis
- * Researchers analyzed records of 530 patients, finding that higher bilirubin concentration and drain discharge volume on POD 1 were significantly associated with POBL.
- * The findings indicate that measuring bilirubin levels in drain fluid can serve as an independent predictor of POBL, aiding in early detection and potentially reducing the need for further interventions.
Article Synopsis
- - A 41-year-old woman experienced anal incontinence after undergoing surgery for a severe perineal laceration during childbirth, leading to a diagnosis of sphincter dysfunction.
- - The treatment included re-suturing the anal sphincter muscle along with a procedure called perineoplasty, which improved the structure and tone of the perineal area.
- - Post-surgery, the woman's symptoms of incontinence greatly improved, as evidenced by a significant drop in her incontinence score and better anal function measurements.
Article Synopsis
- The study compares long-term outcomes of two types of spleen-preserving distal pancreatectomy: one with splenic vessel resection and another with splenic vessel preservation, involving 335 patients who were monitored for 5 years.
- Findings show there were no significant differences in short-term outcomes, but the group with splenic vessel resection had more perigastric varices and lower platelet counts in the long term.
- Other complications like gastric submucosal varices and gastrointestinal bleeding were not significantly different between the two groups after 5 years post-surgery.
Aim: Antiseptics used at surgical sites are vital to preventing surgical site infections (SSI). In this study, a comparative investigation of the novel antiseptics olanexidine gluconate (OG) and povidone-iodine (PI) was conducted to determine whether OG is more effective than PI against SSI after gastrointestinal surgery.
Methods: This prospective, randomized, single-blind, interventional, single-center study was conducted between August 2018 and February 2021.
Many cases with esophageal cancer recurrence have worse clinical survival. Treatment with immune checkpoint inhibitor (ICI)has been reported to result in significantly longer overall survival. We investigated the clinical outcomes in 30 patients with esophageal cancer recurrence who underwent neoadjuvant chemotherapy followed by surgery, chemotherapy, and chemoradiotherapy.
View Article and Find Full Text PDFThe patient was a 60s male. He underwent esophagectomy and gastric tube reconstruction for Barrett's esophageal cancer( pT3N1M0, pStage Ⅲ). Postoperatively, anastomotic leakage and mediastinitis resulted in septic shock.
View Article and Find Full Text PDFPurpose: This study aimed to investigate the risk factors for re-drainage in patients with early drain removal after pancreaticoduodenectomy (PD).
Methods: This study retrospectively analyzed 114 patients who underwent PD and prophylactic drain removal on postoperative day (POD) 4 between January 2012 and March 2021. We analyzed the risk factors for re-drainage according to various factors.
Effect of early administration of tolvaptan on pleural effusion post-hepatectomy.
Langenbecks Arch Surg
October 2023
Article Synopsis
- * Patients were divided into two groups: one received tolvaptan and spironolactone for five days after surgery, while the control group received standard diuretics based on their condition.
- * Results showed that tolvaptan significantly reduced pleural effusion and weight gain after five days, but it did not impact the need for pleural aspiration or length of hospital stay.
Purpose: Candida spp. cause opportunistic infections in conditions of immunodeficiency. Here, we investigated the relationship between colonization of the gastric juice by Candida spp.
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- The study investigates the link between estimated functional remnant pancreatic volume (eFRPV) and postoperative malnutrition in patients who had pancreaticoduodenectomy (PD).
- A review of 131 patients' medical records showed that those with severe malnutrition had a significantly lower eFRPV compared to those without malnutrition.
- Key predictors for severe malnutrition identified were eFRPV ≤55.2 mL·HU, preoperative Onodera’s nutritional index ≤41.9, and body mass index ≤19.1 kg/m², suggesting eFRPV can help assess nutritional status post-surgery.
Article Synopsis
- - The study examined how loss of muscle mass before and after surgery impacts nutrition in patients who had a pancreatectomy, analyzing data from 164 patients between 2011 and 2018.
- - Results showed that patients who experienced significant muscle loss (high-reduction group) had consistently lower nutritional indicators like albumin and cholinesterase, while there was no notable difference between those with and without preoperative sarcopenia.
- - The findings suggest that focusing on preserving muscle mass during the surgical process can help maintain better nutritional health after surgery.
A man in his 80s was referred to our hospital with the chief complaint of perianal erosion. Colonoscopy revealed a peripheral flat lesion in the anal canal. Since immunohistological examination showed positive for CK20 and negative for GCDFP15, we made a preoperative diagnosis of anal canal cancer with Pagetoid spread.
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- Palliative stoma creation for patients with malignant gastrointestinal obstruction can significantly enhance quality of life and contributes to long-term survival due to advancements in chemotherapy.
- A study of 24 patients showed that 96% could eat more than a porridge diet post-surgery, with significant improvements in their bowel obstruction scores.
- However, complications occurred in 42% of patients, with longer hospital stays for those with issues, and long-term survivors were more likely to experience stoma prolapse, highlighting the need for careful surgical techniques and effective post-operative care.
Introduction: Post-hepatectomy liver failure (PHLF) is a serious complication associated with major hepatectomies. An accurate prediction of PHLF is necessary to determine the feasibility of major hepatectomy. This study aimed to assess the association between PHLF and preoperative laboratory and computed tomography (CT) findings.
View Article and Find Full Text PDFBackground: Treatments for patients with gastric outlet obstruction (GOO) due to unresectable pancreatic cancers (URPC) include gastrojejunostomy (GJJ) and endoscopic duodenal stent placement (EDSP). This study compared the efficacy and safety of GJJ and EDSP in patients with GOO due to URPC.
Methods: This study retrospectively evaluated consecutive patients with GOO due to URPC who underwent GJJ or EDSP between April 2016 and March 2020.
Objectives: Nonalcoholic fatty liver is a complication of pancreaticoduodenectomy (PD); however, liver fibrosis after PD is not well documented. Therefore, we estimated the hepatic fibrotic index of nonalcoholic fatty liver after PD.
Methods: We retrospectively examined the electronic medical records of patients who had underwent PD and had computed tomography (CT) records preoperatively and 6 months postoperatively between 2011 and 2019 at the Shiga University of Medical Science Hospital.
Article Synopsis
- Esophageal cancer surgery often results in significant weight loss and poor nutritional status, prompting a study on home enteral tube feeding supplementation (HES) post-surgery.
- The study reviewed 67 esophageal cancer patients, with 40 receiving HES after surgery and 27 not receiving it, and assessed their nutritional status over time.
- Results indicated that those in the HES group experienced less weight loss at both 3 months and 1 year post-surgery compared to the control group, suggesting HES could be beneficial for maintaining weight in these patients.
Objective: This multicenter study aimed to compare the short- and long-term outcomes of laparoscopic (LRLR) versus open repeat liver resection (ORLR) for recurrent hepatocellular carcinoma (HCC) using propensity score matching (PSM). Despite the expanding indications for laparoscopic liver resection, limited data regarding the outcomes of LRLR have previously been reported.
Methods: This study included patients who underwent repeat liver resection for recurrent HCC.
Background: There is no consensus amongst comparative studies about the advantages of robotic over laparoscopic surgeries for gastric cancer (GC). We compared invasiveness and lymph node dissection between robotic and laparoscopic gastrectomies (RG and LG).
Methods: We retrospectively reviewed the medical records of 215 consecutive patients with GC who underwent RG or LG with lymphadenectomy from January 2011-December 2020.
Introduction: We investigated the effect of the gastrojejunostomy position on the postoperative oral intake in patients who have undergone pancreaticoduodenectomy (PD).
Methods: We investigated 119 patients who underwent PD between June 2013 and December 2019 and examined the effect of the horizontal and vertical distance rates of the gastrojejunostomy position on the postoperative oral intake. The patients were categorized as having poor or good oral intake based on whether their intake was up to half the required calorie intake.