Publications by authors named "Ichiro Uyama"
Background: Postoperative pancreatic fistula (POPF) is one of the potentially serious complications after gastrectomy for gastric cancer (GC). Drain amylase level is a predictor of POPF in open and laparoscopic gastrectomy, but no study has focused on minimally invasive surgery (MIS), including robotic gastrectomy (RG). This study assesses the effect of drain amylase levels for POPF in MIS and develop a prediction model in the MIS era.
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Background: In the field of abdominal surgery, including colorectal cancer surgery, robotic surgery has become widespread, and the introduction of new robotic platforms is increasing. As a result, the incidence of subcutaneous emphysema (SE) as a postoperative complication has increased; however, the causes, grade, and perioperative course of SE have not been definitively examined. Therefore, we aimed to evaluate potential risk factors of SE after robotic colorectal cancer surgery.
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- - This study focused on 111 patients with advanced gastric cancer who were treated with nivolumab to monitor their disease progression and evaluate treatment response using serum inflammatory markers like CRP-to-albumin ratio (CAR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR).
- - Results indicated an overall response rate of 11.7% and a disease control rate of 44.1%, with median overall survival of 14 months and progression-free survival of 4.1 months.
- - Changes in the inflammatory markers after therapy proved to be useful in predicting treatment response, with specific cutoff values identified for CAR, PLR, and NLR that correlated
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- Adenosquamous carcinoma of the pancreas (ASCP) is a rare and serious type of cancer, making up only 1-4% of pancreatic cancers, and it doesn't respond well to treatment.
- A 76-year-old woman with stomach pain was found to have a tumor in her pancreas that was originally deemed inoperable due to its involvement with important blood vessels.
- After receiving chemotherapy for several months, the tumor shrank enough to allow for surgery, which was successful, and the patient had a good recovery without major issues.
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- - The study assessed the effectiveness of laparoscopic gastrectomy (LG) performed by non-ESSQS-qualified surgeons when guided by ESSQS-qualified surgeons in patients with stage ≤ III gastric cancer.
- - A total of 1,030 patients were analyzed, with results showing that the 3-year recurrence-free survival rate was slightly higher for non-ESSQS surgeons (84.4%) compared to their ESSQS counterparts (81.7%), indicating non-inferior outcomes.
- - Overall, both patient groups had similar 5-year recurrence-free survival rates and overall survival rates, suggesting that non-ESSQS-qualified surgeons can achieve comparable oncological results in a high-volume center when receiving intraoperative guidance.
Subtotal colectomy is often performed on patients with synchronous colorectal cancer. However, compared with colorectal anastomosis, ileorectal anastomosis with subtotal colectomy is more likely to result in bowel dysfunction. The Deloyers procedure is useful in preserving bowel function in a patient with synchronous colorectal cancer.
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- The study investigates the impact of task division among console surgeons during robotic pancreaticoduodenectomy (RPD) on surgical outcomes and education from 2009 to 2023.
- It compares two methods: a single console surgeon versus multiple surgeons, revealing that the multiple approach significantly reduced operation time and postoperative complications.
- The findings suggest that using a multiple approach not only improves surgical results but also enhances learning opportunities for less experienced surgeons.
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- The study compares two surgical techniques for distal pancreatectomy: robot-assisted approach (RAA) using a laparoscopic vessel-sealing device (LAVSD) and pure-robotic approach (PRA).
- RAA demonstrated significantly shorter operation times and fewer major complications compared to PRA among 62 patients analyzed.
- Despite no statistically significant difference in hospital stay duration, RAA is considered a safe and effective alternative for less experienced surgeons.
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- A study evaluated the effectiveness of improved surgical procedures for preventing late complications in patients undergoing minimally invasive total gastrectomy for gastric cancer, comparing two groups over ten years.
- The researchers found that the rate of late overall complications and intestinal complications significantly decreased after standardizing the surgical procedure, indicating better outcomes for patients.
- Specifically, the incidence of late complications fell from 9.0% in the first group (before standardization) to 2.9% in the second group (after standardization), highlighting Period-I as a risk factor for these complications.
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- * Advances in technology and new surgical robots have mitigated previous challenges, leading to a legal framework in Japan since 2019 that supports remote surgical assistance under a surgeon's supervision.
- * The Japan Surgical Society developed "Telesurgery Guidelines" in June 2022, outlining standards for medical teams, communication protocols, robotic systems, and addressing issues like responsibility and adverse events, with plans for ongoing updates.
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- Pancreatojejunostomy is a complex surgery often performed during robotic pancreaticoduodenectomy (RPD), and the modified Blumgart anastomosis (mBA) method lacks established technical guidelines for robotic use.
- A study at Fujita Health University analyzed data from 78 RPD patients between 2009 and 2023, focusing on the implementation of robotic mBA.
- Results showed a postoperative pancreatic fistula rate of 18%, with no severe complications, and an average anastomotic time of 80 minutes, suggesting that robotic mBA can be a viable standard method for this procedure.
Concurrent direct and indirect inguinal, femoral, and obturator hernias are rare. This case report describes a rare case treated using the laparoscopic approach. A 68-year-old female patient presented with a moving left inguinal lump and pain.
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- * Using a cadaver study, researchers successfully achieved optimal access and suturing for various deep-seated lesions without external incisions, demonstrating improved efficiency compared to traditional methods.
- * The findings suggest that the transoral robotic approach is promising for neurosurgery, with a need for further refinement of instruments and additional studies to solidify its effectiveness for treating both benign and malignant conditions.
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- A 65-year-old male patient with a history of bladder cancer underwent robot-assisted total bladder resection in 2013 and was later diagnosed with advanced rectal cancer in 2022.
- The surgery for rectal cancer involved a low anterior resection, during which extensive abdominal adhesions were found but successfully managed without injuring the urinary reservoir.
- Following the 510-minute surgery with minimal blood loss, the patient remained recurrence-free for 12 months, showcasing the potential benefits of robot-assisted surgery in challenging cases.
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- * Between January 2009 and March 2022, 150 patients underwent the procedure, showing a 12% rate of significant complications and an average hospital stay of 14 days, while 33.3% had positive histological responses.
- * Results indicated that total/proximal gastrectomy with splenectomy had higher complication rates, and robotic surgery appeared to be safer than laparoscopic approaches for such procedures.
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- The hinotori™ Surgical Robot System, recently approved in Japan, was used for the world’s first robotic gastrectomy for gastric cancer in November 2022, indicating advancements in surgical robot technology.
- A study involving 24 gastric cancer patients assessed the feasibility and safety of this procedure, focusing on postoperative complications and surgical outcomes.
- Results showed no severe complications, with most patients experiencing mild issues, and effective surgical performance characterized by low blood loss and significant lymph node dissection.
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- Hydrocele of the canal of Nuck (HCN) is a rare condition, and there's limited understanding of when laparoscopic surgery is needed for it.
- A case study of a 53-year-old woman showed successful laparoscopic treatment for a hydrocele that extended from her abdominal cavity down to the inguinal area, with the surgery involving dissection and mesh reinforcement.
- The laparoscopic approach was deemed effective and safe, reducing risks of injury to surrounding blood vessels compared to traditional methods, highlighting its potential benefits for similar cases.
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- The study compares minimally invasive anatomic liver (sub)segmentectomies (MIAS) with open surgeries (OAS) and evaluates the surgical outcomes of each approach using a matched analysis of 71 cases from each group.
- Results indicate that MIAS leads to significantly better perioperative outcomes, such as reduced blood loss, lower postoperative bilirubin and C-reactive protein levels, and shorter hospital stays, compared to OAS.
- While robotic and laparoscopic methods within MIAS show comparable results for various outcomes, robotic techniques might simplify complex surgeries, especially in certain patient scenarios, despite some increased parameters like postoperative enzyme levels.
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- Robotic pancreaticoduodenectomy (RPD) is complex, requiring 20-50 cases for surgeons to improve, with this study examining 76 RPD cases from a hospital over nearly 14 years to track surgical performance evolution.* -
- Patients were categorized into three groups based on the surgeons' experience: competency, proficiency, and mastery, with significant reductions in operation time and major complications as experience increased across these groups.* -
- Results showed that average operation time significantly decreased from 921.5 minutes to 609.2 minutes, and major complications dropped from 52.2% to 9.1% as surgical techniques were optimized, indicating improved surgeon training and procedural efficiency.*
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- Pancreatic tumor enucleation is a surgical method that removes tumors while preserving pancreatic function, and can be done with minimally invasive techniques.
- The da Vinci SP robotic platform, a new single-port robotics technology, was used for this procedure in a male patient in his 70s with a pancreatic neuroendocrine tumor.
- The surgery took 139 minutes with minimal blood loss (4 mL), and the patient recovered well, going home six days post-operation, suggesting that this method is both effective and less invasive.
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- The study investigates the safety and effectiveness of a robotic esophagectomy (RE) technique that focuses on the outermost layer of autonomic nerves in patients with esophageal cancer.
- A total of 66 patients were analyzed, with most having squamous cell carcinoma, and the majority undergoing successful surgeries without conversion to traditional methods.
- The results showed a moderate complication rate and high resection success, indicating that this approach can yield safe short-term outcomes for patients.