Publications by authors named "Kaji Tatsuru"
Many institutions perform thoracoscopic surgery for pediatric extrapulmonary sequestration (EPS). This approach achieves good cosmetic outcomes due to the small skin incision in comparison to open surgery. However, an extension or additional incision is sometimes necessary to extract resected specimens from the thoracic cavity, which reduces the advantages of this procedure.
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- This study looked at how clodronate, which affects vesicular nucleotide transport, impacts liver inflammation linked to intestinal failure in rats with short bowel syndrome.
- The researchers used a rat model that involved feeding them through a vein and surgically removing most of their small intestine, then giving them different doses of clodronate.
- Results showed that high doses of clodronate reduced liver fat and inflammation in the rats, suggesting potential benefits for patients with similar conditions related to intestinal failure.
Article Synopsis
- * Fourteen patients were analyzed, showing types of IMD such as isolated hypoganglionosis, extensive aganglionosis, and chronic idiopathic intestinal pseudo-obstruction, with a notable 50% mortality rate primarily due to intestinal failure-related liver disease and catheter infections.
- * Cholestasis emerged as a significant predictor of prognosis, highlighting the need to focus on preventing complications like liver disease and infections from long-term TPN to ultimately reduce mortality rates in these patients.
Article Synopsis
- Ultrasound-guided supraclavicular catheterization (UGSC) of the brachiocephalic vein for long-term central venous catheter insertion is being assessed for its safety compared to the internal jugular vein approach.
- A study conducted between January 2018 and December 2023 involved 177 insertions across different experience levels, including junior, senior residents, and board-certified pediatric surgeons.
- While junior residents had longer operation times, they were able to perform UGSC without significant complications, suggesting they can safely conduct the procedure if cases are selected carefully.
Article Synopsis
- * Out of 43 patients analyzed, 69.8% experienced cholangitis, with significant episodes occurring before age 3; however, key inflammatory markers were similar between patients with native liver survival (NLS) and those undergoing liver transplants (LDLT).
- * Notably, the NLS group showed a lower neutrophil-to-lymphocyte ratio, indicating a lymphocyte-dominant form of cholangitis, suggesting different pathways in its development—highlighting the need for further research to guide better treatment and outcomes for BA patients
Purpose: This study aimed to investigate the impact of hepatocyte growth factor (HGF) on colonic morphology and gut microbiota in a rat model of short bowel syndrome (SBS).
Methods: SD rats underwent jugular vein catheterization for total parenteral nutrition (TPN) and 90% small bowel resection [TPN + SBS (control group) or TPN + SBS + intravenous HGF (0.3 mg/kg/day, HGF group)].
Purpose: We explored factors affecting gastric emptying in neurologically impaired (NI) patients using the C-acetate breath test.
Methods: Twenty-four NI patients were classified by the presence of gastroesophageal reflux disease (GERD), which was treated by fundoplication plus gastrostomy, or the absence of GERD, which was treated by gastrostomy alone, along with gastric malposition involving cascade stomach and organoaxial gastric volvulus (OGV). Gastric emptying parameters (GEPs), which were the emptying half time (T , minute), the lag phase time (T , minute), and the gastric emptying coefficient (GEC), were measured before and after surgery.
Background: We evaluated the effect of recombinant human hepatocyte growth factor (rh-HGF) on intestinal adaptation in a rat model of short-bowel syndrome (SBS).
Methods: Sprague-Dawley rats underwent jugular vein catheterization for continuous total parenteral nutrition (TPN) and 90 % small bowel resection. The animals were divided into 3 groups: TPN/SBS (control group, n = 7), TPN/SBS/intravenous recombinant human hepatocyte growth factor (HGF) (0.
Article Synopsis
- This study aimed to explore how autophagy is linked with apoptosis in liver damage within a rat model that simulates short bowel syndrome (SBS).
- Rats were divided into two groups to receive different treatments: one group received standard care (Control) and the other received hepatocyte growth factor (HGF).
- Results showed that HGF treatment reduced liver inflammation and injury markers while possibly enhancing cell survival, indicating a complex role in liver health that needs further investigation.
Article Synopsis
- Anovestibular fistula (AVF) is the most common type of anorectal malformation (ARM) in females, and a study analyzed the long-term defecation function in 88 female patients post-surgery.* -
- The research evaluated patient outcomes based on surgeries (anal transposition and anterior sagittal anorectoplasty) and found that overall, patients achieved “excellent” bowel function by age nine, though the type of surgery influenced results.* -
- Ultimately, while most AVF patients experienced positive bowel function outcomes, the study highlighted the importance of individualized long-term management based on surgical approach and specific complications.*
Article Synopsis
- - The study evaluated differences between biliary atresia patients with a bleeding tendency (BT) and those without (NBT) regarding their clinical features and outcomes at diagnosis.
- - Among the 93 patients, 9.7% had a BT, primarily involving intracranial hemorrhage, but no significant differences were found in age at initial visit, timing of surgery, or survival rates between the two groups.
- - The findings suggest that timely correction of the bleeding tendency allows for early surgical intervention (KPE) in BT patients, leading to comparable survival outcomes and minimal neurological complications.
Background: Duplication of the alimentary tract can occur in any of its parts. For duodenal duplication, complete resection is particularly difficult when the ampulla of Vater is on the duplicated lumen and a deliberate management is necessary.
Case Presentation: A 0-day female baby was referred to our department due to abdominal distention.
Proctoring System of Pediatric Laparoscopic Surgery for Choledochal Cyst.
J Laparoendosc Adv Surg Tech A
November 2023
Endoscopic surgery also has been becoming widespread in the field of pediatric surgery. However, most disease treated by pediatric surgery in a single institution are small number of cases. Besides, the variety of operative procedures that need to be performed in this field is quite wide.
View Article and Find Full Text PDFEfficacy and Safety of Teduglutide in Infants and Children With Short Bowel Syndrome Dependent on Parenteral Support.
J Pediatr Gastroenterol Nutr
September 2023
Objectives: Our objective was to evaluate the short- and long-term safety and efficacy of teduglutide treatment in infants and children with short bowel syndrome with intestinal failure (SBS-IF).
Methods: Two open-label phase 3 studies and 1 extension study investigated the short- and long-term safety and efficacy of teduglutide (0.05 mg/kg/day) in infants and children with SBS-IF: NCT03571516, 24-week study of infants who were randomized to receive teduglutide or standard of care (SoC); NCT02980666, 24-week study of infants and children who all received teduglutide; and NCT03268811, 24-week extension study of patients who completed NCT02980666 (patients could receive up to 48 weeks of total treatment).
We, herein, report a surgical technique for laparoscopy-assisted jejunostomy tube placement in an infant using a loop needle device to fix the jejunum and abdominal wall. A 3-year-old boy with Down's syndrome underwent nutritional management by gastrostomy due to oral feeding difficulty after radical surgery for congenital duodenal stenosis and following bile duct stenosis. However, intractable gastrostomy site leakage emerged; hence, laparoscopy-assisted gastrostomy takedown and simultaneous laparoscopy-assisted jejunostomy tube placement were planned.
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- The study aimed to clarify the characteristics of solid organ injuries in children, analyzing cases from two institutions over a 14-year period.
- The review included 47 cases, with liver injuries being the most common, and found that most patients were treated conservatively, while some required intervention or surgery.
- Complications were relatively low, with no reported deaths, indicating that pediatric patients generally had positive outcomes after blunt trauma treatment at these centers.
Background: The repair of large abdominal wall defects that cannot be closed primarily is quite challenging. The component separation technique (CST) is a surgical approach using autologous tissue to close large abdominal wall defects. The CST requires extensive dissection between the abdominal skin and the anterior sheath of the rectus abdominis muscle.
View Article and Find Full Text PDFIntroduction: Surgical management of neuroblastoma (NB) has been performed by open procedures for decades. However, advances in surgical devices and technology have made minimally invasive surgery safe and reproducible. In this study, we compared open and laparoscopic surgery regarding biopsy success and curative resection to determine the safety and feasibility of laparoscopic surgery for pediatric patients with adrenal NB.
View Article and Find Full Text PDFPurpose: Midgut volvulus is an urgent disease often occurring in neonates. This study clarified the clinical features of midgut volvulus and evaluated predictors to avoid bowel resection.
Methods: This bi-center retrospective study enrolled 48 patients who underwent surgery for intestinal malrotation between 2010 and 2022.
Article Synopsis
- - The study examined the effectiveness of repetitive laparoscopic surgery training with a simulator specific to congenital biliary dilatation (CBD) in kids, focusing on skill improvement and clinical surgery outcomes.
- - Four pediatric surgeons practiced laparoscopic hepaticojejunostomy three times using a high-fidelity simulator, resulting in significantly faster task completion times by the third attempt, although other performance metrics like forceps path length and velocity showed no significant changes.
- - Clinical results for 13 CBD surgeries performed by these trained surgeons indicated successful outcomes with no conversion to open surgery, minimal blood loss, and no serious complications, suggesting that simulator training enhances laparoscopic surgical safety and quality.
Purpose: Various prognostic predictors for biliary atresia (BA) have been identified. This study aimed to evaluate the serial changes in the preoperative and postoperative ubiquitous inflammatory biomarkers and their relationship with the outcomes in patients with BA.
Patients And Methods: Forty-three BA patients were retrospectively reviewed to investigate serial levels of ubiquitous inflammatory biomarkers, including C-reactive protein (CRP) and lymphocyte ratio, and outcomes.
Purpose: Representative neonatal surgical diseases are often complicated by congenital heart disease (CHD). We reviewed our decade of experience from the perspective of the prognosis and report on the management of infants with CHD.
Methods: Cases with and without CHD between 2011 and 2020 were retrospectively compared.
Article Synopsis
- - The study compares anemia cases in infants with gastroschisis and omphalocele, analyzing data from 60 patients across five pediatric surgery departments in southern Japan from 2011 to 2020.
- - Results indicated that infants with gastroschisis received more iron treatment during hospitalization but had lower hemoglobin levels at their first outpatient visit compared to those with omphalocele, highlighting significant risk factors for anemia related to gastroschisis and gestational age at birth.
- - The findings suggest that infants with gastroschisis are at a higher risk of anemia, potentially due to their unique exposure to amniotic fluid and the impact it has on their intestinal health in utero.
How we acquire suturing skills for laparoscopic hepaticojejunostomy.
Asian J Endosc Surg
October 2022
Laparoscopic choledochal cyst excision and hepaticojejunostomy is a representative surgical procedure requiring laparoscopic suturing including needle driving and knot tying. Laparoscopic needle driving and knot tying is a highly technically demanding skill, especially in small infants and children. We developed a laparoscopic hepaticojejunostomy simulator for training.
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- A 13-year-old boy presented with abdominal pain and a palpable mass, leading to a CT scan that revealed a bulky tumor in the ascending colon and metastases in lymph nodes.
- The planned surgical intervention involved laparoscopic radical resection, which included the removal of the tumor, the right-side colon, and surrounding lymph nodes through a 6-cm incision.
- Pathological analysis confirmed the tumor as Burkitt-like lymphoma with 11q aberration, and the patient's recovery after surgery was smooth, highlighting the viability of laparoscopic approaches for pediatric tumors with careful planning.