Publications by authors named "Kay Uehara"
The sustainability of the surgical workforce, environmental pollution caused by disposable instruments, and the rising costs of medical care are pressing issues worldwide. This review explores sustainable surgical practices for laparoscopic surgery through the application of surgical AI systems and reusable energy devices. Surgical AI systems enable the precise real-time visualization of organ anatomy, enhance surgical accuracy, and support educational initiatives.
View Article and Find Full Text PDFFor patients with resectable colorectal liver metastases (CRLM), the efficacy of adjuvant chemotherapy remains a subject of debate. Several studies have concluded that postoperative circulating tumor DNA (ctDNA) is a marker of minimal residual disease (MRD) and is a useful prognostic factor in patients with nonmetastatic colorectal cancer. However, few studies have explored its application in cases involving metastases.
View Article and Find Full Text PDFAim: The best modality for evaluating lateral pelvic lymph node (LPLN) metastases from rectal cancer remains unclear. This study compared the diagnostic ability of 1-mm computed tomography (CT) and 3-mm magnetic resonance imaging (MRI) in identifying LPLN metastases based on size.
Methods: This observational study analyzed not individual patients but 191 sides from 100 rectal cancer patients without preoperative treatment for whom preoperative CT and MRI and corresponding pathological results for LPLNs were available.
Background/objectives: BRAF mutations occur in 5-10% of metastatic colorectal cancer (mCRC) cases, but their implications for prognosis and optimal treatment remain unclear.
Methods: This multicenter, prospective observational study analyzed 377 RAS wild-type cases from 511 patients across 32 centers, using PCR-based methods.
Results: BRAF mutations were identified in 21% (79/377) of cases, predominantly V600E (89.
The epithelial and mesenchymal features of colorectal adenocarcinoma (CRAC) cell lines were compared in two-dimensional (2D) and three-dimensional (3D) cultures. In 2D cultures, the three CRAC cell lines exhibited epithelial characteristics with high E-cadherin and low vimentin levels, whereas two exhibited mesenchymal traits with opposite expression patterns. In 3D cultures using low-attachment plates, mesenchymal cells from 2D cultures showed reduced vimentin mRNA levels.
View Article and Find Full Text PDFObjective: To investigate the incidence of male sexual dysfunction (SD) including erectile dysfunction (ErD) and ejaculatory dysfunction (EjD) after minimally invasive rectal cancer surgery.
Background: Male SD significantly affects post-rectal cancer surgery quality of life (QOL). Current assessments using the International Index of Erectile Function-5 are unsuitable for patients with reduced postoperative sexual activity, because it assumes sexual intercourse.
Article Synopsis
- A systematic review and meta-analysis was conducted to compare the safety and effectiveness of laparoscopic versus open surgery after SEMS placement in patients with obstructive colorectal cancer.
- The analysis included data from 15 studies with 883 patients and showed that laparoscopic surgery had a significantly lower postoperative complication rate compared to open surgery.
- However, there were no significant differences in long-term outcomes, such as 3-year recurrence-free survival and overall survival rates, between the two surgical approaches.
Article Synopsis
- The study investigates risk factors for lateral lymph node metastasis in rectal cancer and aims to improve diagnostic accuracy using machine learning models.
- It analyzed data from patients who underwent lymph node dissection without prior treatment across 15 Japanese hospitals from 2017 to 2019, focusing on preoperative factors and MRI findings.
- Results identified key risk factors and developed machine learning models, showing that poorly differentiated adenocarcinoma and certain tumor characteristics significantly increase the likelihood of metastasis.
Background: The significance of resection of para-aortic lymph node metastasis in colorectal cancer is controversial.
Objective: To clarify the prognosis of colorectal cancer after para-aortic lymph node metastasis resection.
Design: Multicenter retrospective study.
Article Synopsis
- * A total of 189 patients who underwent total mesorectal excision and LLND were included, and data on local recurrence (LR) and lateral lymph node recurrence (LLNR) were analyzed after matching similar patient characteristics.
- * While 39 patients had pathological LLNM, the analysis showed similar rates of LR and LLNR in both groups after balancing their characteristics, suggesting LLND can provide comparable local control regardless of LLNM presence.
Background/aim: A deep ultraviolet (DUV) light-emitting diode (LED) is a device that can irradiate electromagnetic waves from 250 nm to 350 nm. Tousled-like kinase 1 (TLK1) encodes a nuclear serine/threonine kinase, which is thought to influence the effects of DUV irradiation in cancer. The aim of this study was to clarify the interaction of TLK1 with DUV irradiation-induced DNA damage in cancer cells.
View Article and Find Full Text PDFAim: The significance of lymphadenectomy and its indications in patients with inguinal lymph node metastasis (ILNM) of anorectal adenocarcinoma is unclear. This study aimed to clarify the surgical outcomes and prognostic factors of inguinal lymphadenectomy for ILNM.
Method: This study included patients who underwent surgical resection for ILNM of rectal or anal canal adenocarcinoma with pathologically positive metastases between 1997 and 2011 at 20 participating centres in the Study Group for Inguinal Lymph Node Metastasis from Colorectal Cancer organized by the Japanese Society for Cancer of the Colon and Rectum.
Article Synopsis
- This study investigates the survival benefits of adjuvant chemotherapy in patients with obstructive colorectal cancer (OCRC) who received self-expandable metallic stent (SEMS) placement as a bridge to surgery.
- The research included 129 patients, divided into two groups: one that received adjuvant chemotherapy after surgery and one that did not, revealing a significant difference in relapse-free survival (RFS) rates (56.4% for no chemotherapy vs. 78.5% for chemotherapy).
- The findings suggest that adjuvant chemotherapy improves survival outcomes, particularly in patients with advanced cancer characteristics, making it highly recommended for OCRC patients undergoing SEMS management.
Article Synopsis
- Emergency surgery for complicated appendicitis has high risks, and interval appendectomy (IA) can reduce complications, though some patients still need emergency surgery if nonoperative management fails.
- A study analyzed the surgical outcomes of patients over nearly a decade, revealing that emergency surgery had more severe complications than successful interval appendectomy, with nonoperative management succeeding in about 76% of cases.
- Certain factors like lack of abscesses, existing health issues, high white blood cell count, and presence of free air were linked to nonoperative management failure, suggesting that while IA is generally effective, patients with these risk factors need close monitoring for potential surgery.
Purpose: Self-expandable metallic stent (SEMS) placement is widely used as a bridge to surgery (BTS) procedure for obstructive colorectal cancer. However, evidence regarding the optimal interval between SEMS placement and elective surgery is lacking.
Methods: We retrospectively collected data from patients with BTS between January 2013 and October 2021.
Aim: The aim of this study was to clarify the significance of resection of ovarian metastases from colorectal cancer and to identify the clinicopathologic characteristics.
Methods: In this multicenter retrospective study, we evaluated data on ovarian metastases from colorectal cancer obtained from patients at 20 centers in Japan between 2000 and 2014. We examined the impact of resection on the prognosis of patients with ovarian metastases and examined prognostic factors.
Aim: Although the oncological impact of lateral lymph node dissection on enlarged lateral lymph nodes has been gradually accepted over the last decade, that on lateral lymph nodes without swelling remains doubtful. This study aimed to develop a prediction model for the future risk of lateral local recurrence and to clarify the value of adding lateral lymph node dissection in locally advanced rectal cancer without enlarged lateral lymph nodes.
Methods: This retrospective, multi-institutional study recruited 812 patients with cStage II/III low rectal cancer without enlarged lateral lymph nodes <7 mm.
Article Synopsis
- The gut microbiome plays a significant role in colorectal cancer (CRC) development and progression, with a specific focus on a type of E. coli that produces a harmful genotoxin called colibactin.
- In a study of 413 CRC patients, higher levels of this E. coli were found in early-stage tumors (Stages 0-I) compared to normal tissue and later-stage tumors (Stages II-IV).
- Patients with lower or absent levels of this E. coli showed worse CRC-specific survival and shorter relapse-free survival, suggesting it may contribute to the initial stages of cancer but not necessarily to its progression.
Background: A colovesical fistula (CVF) is commonly treated by resection of the intestine containing the fistula or creation of a defunctioning stoma. We herein report a case of successful fistula closure and avoidance of colostomy after placement of a covered colonic self-expanding metallic stent (SEMS) as a palliative treatment for a malignant CVF.
Case Presentation: A 75-year-old man undergoing infusional 5-fluorouracil and irinotecan chemotherapy plus bevacizumab for recurrent peritoneal dissemination of rectal cancer was admitted to our hospital because of fecaluria with a high-grade fever.
Objectives: Despite the high incidence of urinary dysfunction (UD) after rectal surgery, it remains questionable whether UD causes future chronic kidney disease (CKD). This study aimed to clarify the long-term trends in renal function and risk factors for future CKD after rectal resection.
Methods: For comparison, patients who underwent rectal resection (n = 129) and colectomy (n = 127) between 2006 and 2017 were identified.
Article Synopsis
- Colorectal cancer (CRC) presents a significant risk for patients with Crohn's disease (CD), and this study aimed to investigate the prognosis and characteristics of CD-related CRC (CD-CRC) compared to sporadic CRC using a large database of cases.
- The analysis included 233 CD-CRC patients and 129,783 sporadic CRC patients, revealing that CD-CRC patients were typically younger, more likely to have rectal cancer, multiple tumors, and a distinct type of cancer called mucinous adenocarcinoma, all resulting in lower survival rates.
- The findings showed a lower five-year overall survival rate for CD-CRC (53.99% vs. 71.17% for sporadic CRC