Publications by authors named "Koshiro Sugita"
Purpose: Cholestatic liver damage is frequently observed in extremely low-birth-weight infants (ELBWIs) followed by enterostomy. We retrospectively investigated the factors related to liver damage.
Methods: ELBWIs who underwent enterostomy at our institution between January 2013 and December 2022 for gastrointestinal disease during the neonatal period were reviewed.
We herein report a neonatal case showing specific findings of blood perfusion in the anastomosed esophagus of esophageal atresia (EA) and tracheoesophageal fistula (TEF) using indocyanine green (ICG) fluorescence during thoracoscopic surgery. The patient was a 3054 g, 0-day neonatal boy diagnosed with EA-TEF based on a coil-up sign of the nasogastric tube. Thoracoscopic surgery was performed on Day 4 after birth.
View Article and Find Full Text PDFPurpose: This study aimed to investigate the current practices in the diagnosis and surgical management of anorectal malformations (ARMs) in female patients in Japan, specifically focusing on anovestibular fistula (AVF), rectovaginal fistula (RVF), and persistent cloaca (PC).
Methods: An anonymous online survey was conducted with 61 institutional members of the Japanese Study Group for Anorectal Anomalies.
Results: Sixty-one institutions (100%) completed the survey.
Purpose: This study investigated the anti-inflammatory effect of clodronate, a vesicular nucleotide transporter (VNUT) inhibitor, on intestinal-failure-associated liver disease (IFALD) in a rat model of short bowel syndrome (SBS).
Methods: The rats underwent jugular vein catheterization for continuous total parenteral nutrition (TPN) and 90% small bowel resection. The animals were divided into the following groups: TPN/SBS (Control group), TPN/SBS/intravenous administration of low-dose clodronate (20 mg/kg twice per week; Low group), or TPN/SBS/intravenous administration of high-dose clodronate (60 mg/kg twice per week; High group).
Article Synopsis
- The study explores how the branching of the portal vein and lymphatic vessels contribute to liver atrophy in biliary atresia (BA).
- Liver biopsy samples from ten BA patients were analyzed using specific staining techniques to compare the left lateral segment (LLS) and right anterior segment (RAS) of the liver.
- Findings indicated that the LLS had higher fibrosis scores and showed a significant correlation between lymphatic vessel numbers and both fibrosis and age at surgery, suggesting a link between lymphatic growth and liver damage in BA.
Purpose: To analyze and compare the outcomes in patients with anorectal malformation with rectoprostatic and rectourethral fistula between laparoscopic-assisted anorectoplasty (LAARP) versus posterior sagittal anorectoplasty (PSARP).
Method: We performed a retrospective review on all males with anorectal malformation (ARM) with recto-prostatic (ARM-RP) or recto-bulbar urethral fistula (ARM-RB) treated in five tertiary paediatric surgical centres in the past 25 years. Defecative function was assessed using the Krickenbeck classification and Kelly's score.
Article Synopsis
- This study examines the diagnosis and treatment practices for rectourethral fistulas (RUF) in male patients with anorectal malformations (ARMs) in Japan, using a comprehensive questionnaire survey among medical institutions.
- Results show that laparoscopic-assisted anorectoplasty (LAARP) is favored for high-type ARMs, while posterior sagittal anorectoplasty (PSARP) is preferred for intermediate-type ARMs, highlighting differences in surgical techniques and tools used.
- The findings indicate distinct management strategies for RUF in PSARP and LAARP procedures, suggesting the need for more research on postoperative outcomes related to these varied approaches.
Background: We conducted a nationwide survey of persistent cloaca (PC) to investigate the renal function outcomes and factors affecting chronic kidney disease (CKD) in patients with PC.
Method: Information from 466 patients with PC was obtained via a questionnaire in this study. The 290 patients (62.
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 investigated the postoperative renal function in persistent cloaca (PC) patients who underwent posterior sagittal anorecto-urethro-vaginopalsty (PSARUVP) and factors influencing the renal functional outcomes.
Methods: A questionnaire survey was distributed to 244 university and children's hospitals across Japan. Of the 169 patients underwent PSARUVP, 103 patients were enrolled in the present study.
Article Synopsis
- A 6-year-old girl was diagnosed with an ovarian endometrioma (OE) after experiencing abdominal pain and vomiting, which led to imaging tests.
- Ultrasound and MRI revealed a multilocular cystic lesion near her bladder, and a further CT scan suggested the lesion originated from her left ovary.
- This case is notable because it represents one of the youngest instances of an OE being identified in a patient who has not yet started menstruating, highlighting the rarity of such occurrences in pediatric populations.
Article Synopsis
- Transumbilical laparoscopy-assisted appendectomy (TULAA) is preferred for treating appendicitis but is harder for trainees to learn than conventional three-port laparoscopic appendectomy (CTPLA) in children.
- A study analyzed surgical outcomes of 225 pediatric patients with appendicitis treated via either TULAA or CTPLA by pediatric surgeons in training from April 2016 to December 2022.
- Results showed TULAA had shorter operative and pneumoperitoneum times compared to CTPLA; however, TULAA had a higher—but not statistically significant—rate of surgical site infections, particularly notable in uncomplicated cases.
Evaluation of skill acquisition characteristics depending on the size of a dry box.
Minim Invasive Ther Allied Technol
August 2024
Background: Few studies have analyzed the effect of the size of the working space in training on the acquisition of endoscopic skills. In this study, adult- and infant-sized dry boxes (DBs) were used to verify how the size of the working space in training affects forceps manipulation and learning curve.
Material And Methods: Seventy-two medical students were enrolled.
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
- - The study compared clinical features and outcomes of intestinal malrotation in two groups: neonates and older children, finding that neonates had a higher frequency of midgut volvulus and related symptoms.
- - A total of 80 patients were reviewed, revealing that while symptoms didn’t significantly differ by age, the severity of bowel torsion was greater in older children, indicating they're at risk for more severe complications.
- - It was concluded that even mild torsion in neonates can lead to serious bowel ischemia, emphasizing the need for prompt diagnosis and treatment in this population.
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.
Purpose: After conducting a nationwide survey of persistent cloaca (PC), we assessed whether or not the timing of definitive anorectoplasty affects the long-term bowel function of patients with PC.
Methods: Patient information was obtained via questionnaire, and a total of 169 PC patients who underwent posterior sagittal anorectourethrovaginoplasty (PSARUVP) were enrolled in this study. Patients were classified into 2 groups based on their operative period, which was analyzed by the area under the receiver operating characteristic curve: the early group (EG) underwent anorectoplasty at ≤ 18 months old (n = 106), and the late group (LG) underwent anorectoplasty at > 18 months old (n = 63).
Near-infrared (NIR) fluorescence imaging with indocyanine green (ICG) has gained popularity in pediatric surgery as it has in general surgery. In addition, a water-jet dissector (WJD) has been successfully introduced in adult hepatic surgery. Tissue structures are dissected selectively and gently by the WJD.
View Article and Find Full Text PDFPurpose: Cloacal exstrophy (CE) patients may need bladder reconstruction after initially undergoing surgery to obtain continence and improve their quality of life. This study attempts to clarify the clinical features of CE patients who underwent bladder augmentation (BA) and their urinary functional outcomes based on a nationwide survey in Japan.
Methods: A questionnaire survey was conducted, and 150 CE patients were enrolled.