Risk factors for postoperative complications in laparoscopic and robot-assisted surgery for octogenarians with colorectal cancer: A multicenter retrospective study.

Aim: Minimally invasive surgery for colorectal cancer is increasing globally. However, the safety in older patients have not been thoroughly examined.

Methods: Patients with colorectal cancer who underwent laparoscopic or robot-assisted surgery at Kyoto University Hospital and 18 affiliated institutions in Japan that participated in the Kyoto Colorectal Surgery Group between 2018 and 2023 were enrolled.

Clinical features by disease duration in ulcerative colitis-associated cancers.

Aim: Ulcerative colitis (UC) is a known contributor to the development of colitis-associated cancer (CAC), although the exact mechanism remains to be elucidated. CAC typically presents as a flat type macroscopically and manifests histologically as mucinous carcinoma and signet ring cell carcinoma. While the relationship between disease duration and chronic inflammation has been studied, the impact of disease duration on CAC outcomes has yet to be thoroughly investigated.

A comparison of the diagnostic ability of 1-mm computed tomography and 3-mm magnetic resonance imaging for detecting lateral pelvic lymph node metastases from rectal cancer.

Aim: 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.

Perioperative changes in the quality of life and the impact of preoperative quality of life on the time to return to work after surgery among patients with colorectal cancer: a prospective, multicenter, cohort study.

Purpose: This study investigated perioperative changes in quality of life (QOL) and the impact of preoperative QOL on the time to return to work (RTW) after surgery in patients with colorectal cancer.

Methods: Patients with clinical stage I-III colorectal cancer who were employed at the diagnosis and scheduled for curative surgery between 2019 and 2020 were prospectively enrolled at 7 hospitals in Japan. The patients' EORTC-QLQ-C30 scores and employment status were collected before and at 6 and 12 months after surgery and compared using a paired t test.

Robotic Laparoscopy and Endoscopy Cooperative Surgery for Primary Appendiceal Mucinous Carcinoma Masquerading as Bladder Cancer: A Case Report.

Bladder invasion by appendiceal cancer resulting in a vesico-appendiceal fistula is an uncommon occurrence. Both radical tumor removal and functional preservation of the bladder are desirable in the surgical treatment of this disease, and there are few reports on detailed surgical methods. Here, we describe a case of primary appendiceal mucinous carcinoma with bladder invasion treated with robotic laparoscopy and endoscopy cooperative surgery (RECS).

Risk factors for local recurrence in patients with clinical stage II/III low rectal cancer: A multicenter retrospective cohort study in Japan.

Background: Identifying risk factors for local recurrence (LR) is pivotal in optimizing rectal cancer treatment. Total mesorectal excision (TME) and lateral lymph node dissection (LLND) are the standard treatment for advanced low rectal cancer in Japan. However, large-scale studies to evaluate risk factors for LR are limited.

Cervical-First Approach in Thoracoscopic Esophagectomy With Intraoperative Nerve Monitoring for an Esophageal Cancer Patient With Aberrant Right Subclavian Artery.

An aberrant right subclavian artery (ARSA) is a rare vascular anomaly accompanied by nonrecurrent inferior laryngeal nerve (NRILN). Here, we described the cervical-first approach in thoracoscopic esophagectomy for an esophageal cancer patient with ARSA using the intraoperative nerve monitoring (IONM) system. First, a left cervical procedure proceeded to expose the left vagus nerve to attach the APS electrode of the IONM system, and the left cervical paraesophageal lymph nodes was dissected separately.

Sciatic Nerve Preservation in Robot-Assisted Surgery for Initially Unresectable Primary Rectal Cancer: A Case Report.

Radical surgery for rectal cancer with bulky lateral pelvic lymph node (LPLN) metastasis involving the sciatic nerve presents both technical and oncological challenges. Preoperative multidisciplinary treatments have recently been anticipated to control the disease as well as to preserve organ function. A 51-year-old man, presenting with right buttock pain and impairment of walking, was diagnosed with sciatic nerve impairment due to right LPLN metastasis from rectal cancer.

Dual inhibition of oxidative phosphorylation and glycolysis exerts a synergistic antitumor effect on colorectal and gastric cancer by creating energy depletion and preventing metabolic switch.

Pyruvate is situated at the intersection of oxidative phosphorylation (OXPHOS) and glycolysis, which are the primary energy-producing pathways in cells. Cancer therapies targeting these pathways have been previously documented, indicating that inhibiting one pathway may lead to functional compensation by the other, resulting in an insufficient antitumor effect. Thus, effective cancer treatment necessitates concurrent and comprehensive suppression of both.

Prospective Multicenter Comprehensive Survey on Male Sexual Dysfunction following Laparoscopic, Robotic, and Transanal Approaches for Rectal Cancer (the LANDMARC Study).

Objective: 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.

Neoadjuvant chemoradiotherapy is associated with prolonged relapse free survival in patient with MRI-detected extramural vascular invasion (mrEMVI) positive rectal cancer: A multicenter retrospective cohort study in Japan.

Purpose: Neoadjuvant chemoradiotherapy (nCRT) is employed for the local control of locally advanced rectal cancer; however, its prognostic impact is limited and often impairs pelvic organ function. Therefore, careful patient selection is essential. This study aimed to investigate the impact of nCRT on relapse-free survival (RFS) by stratifying patients according to MRI detected circumferential resection margin (mrCRM) or extramural vascular invasion (mrEMVI), as the ability of MRI findings to identify patients who will have beneficial outcomes from nCRT is uncertain.

Relationship between hospital surgical volume and the perioperative esophagectomy costs for esophageal cancer: a nationwide administrative claims database study.

Background: Numerous studies have described positive relationships between hospital volume (HV) and clinical outcomes in highly complex procedures, including esophagectomies. Although the centralization of surgery has been considered a possible solution for improving clinical outcomes, the HV impact on perioperative healthcare costs is unknown. This study aimed to determine the relationship between HV and perioperative healthcare costs for patients undergoing esophagectomy for esophageal cancer.

Identification of lateral pelvic nodes without metastasis in patients with rectal cancer treated with preoperative chemoradiotherapy or chemotherapy based on magnetic resonance imaging.

Background: Intensive localized therapy is promising for the treatment of rectal cancer. In Japan, chemoradiotherapy (CRT) and neoadjuvant chemotherapy (NAC) are used as preoperative treatments for this disease. Magnetic resonance imaging (MRI) is used to diagnose lateral pelvic node (LPN) metastases, but the changes in LPN findings on MRI following preoperative treatment are unclear.

Laparoscopic vs. open surgery for rectal cancer in patients with obesity: short-term outcomes and relapse-free survival across age groups.

Purpose: To investigate the efficacy of laparoscopic surgery for rectal cancer in obese and older patients, who are often characterized by a higher prevalence of comorbidities and physical decline.

Methods: This large-scale multicenter retrospective cohort study included 524 patients with a body mass index of 25 or higher who underwent either open or laparoscopic surgery for stage II or III rectal cancer between 2009 and 2013. We assessed the short-term outcomes and relapse-free survival by comparing these surgical modalities.

Low-grade appendiceal mucinous neoplasm penetrating sigmoid colon: A case report.

Low-grade appendiceal mucinous neoplasm (LAMN) is principally characterized by low-grade cytology without evidence of invasion to other organs. We report a LAMN surgical case whose appendiceal tumor penetrated the sigmoid colon wall. An 87-year-old man was referred for endoscopic resection (ER) of a colon polyp.

The potential of an artificial intelligence for diagnosing MRI images in rectal cancer: multicenter collaborative trial.

Background: An artificial intelligence-based algorithm we developed, mrAI, satisfactorily segmented the rectal tumor, rectum, and mesorectum from MRI data of rectal cancer patients in an initial study. Herein, we aimed to validate mrAI using an independent dataset.

Methods: We utilized MRI images collected in another nationwide research project, "Open versus Laparoscopic Surgery for Advanced Low Rectal Cancer Patients".

Long-term Outcome After Surgical Resection of Para-aortic Lymph Node Metastasis of Colorectal Cancer: A Multicenter Retrospective Study.

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.

Local Recurrence of Rectal Cancer After Transanal Total Mesorectal Excision and Risk Factors: A Nationwide Multicenter Cohort Study in Japan.

Objective: To investigate the oncological outcomes after transanal total mesorectal excision (TaTME) for rectal cancer and risk factors for local recurrence (LR).

Background: A high LR rate with a multifocal pattern early after TaTME has been reported in Norway and the Netherlands, causing controversy over the oncological safety of this technique.

Methods: Twenty-six member institutions of the Japan Society of Laparoscopic Colorectal Surgery participated in this retrospective cohort study.

Appendiceal neoplasms derived from appendiceal tip remnants following appendectomy: a report of two cases.

Background: Neoplasms derived from remnant appendix are rarely described, with most cases arising from the appendiceal "stump". Here, we present two surgical cases of appendiceal neoplasms derived from appendiceal "tip" remnants.

Case Presentation: The first patient was a 71-year-old man who had undergone laparoscopic appendectomy for acute appendicitis 12 years prior.

Right-sided versus left-sided colorectal cancer in elderly patients: a sub-analysis of a large multicenter case-control study in Japan.

Purpose: This study investigated the impact of sidedness of colorectal cancer (CRC) in elderly patients on the prognosis.

Methods: In a sub-analysis of a multicenter case-control study of CRC patients who underwent surgery at ≥ 80 years old conducted in Japan between 2003 and 2007, both short- and long-term outcomes were compared between right-sided colon cancers (RCCs) and left-sided colorectal cancers (LCCs). RCCs were defined as those located from the cecum to the transverse colon.

Real-time detection of active bleeding in laparoscopic colectomy using artificial intelligence.

Background: Most intraoperative adverse events (iAEs) result from surgeons' errors, and bleeding is the majority of iAEs. Recognizing active bleeding timely is important to ensure safe surgery, and artificial intelligence (AI) has great potential for detecting active bleeding and providing real-time surgical support. This study aimed to develop a real-time AI model to detect active intraoperative bleeding.

Evaluation of the advantage of surgeons certified by the endoscopic surgical skill qualification system participating in laparoscopic low anterior rectal resection.

Background: A technical qualification system was developed in 2004 by the Japan Society for Endoscopic Surgery. An analysis of the EnSSURE study on 3188 stage II-III rectal cancer patients, which was performed by including the participation of qualified surgeons as assistants and advisers without restricting their participation as operators, revealed that the participation of technically qualified surgeons in surgery improved the technical and oncological safety of laparoscopic rectal resection.

Aim: This secondary retrospective analysis of the EnSSURE study examined the advantage of qualified surgeons participating in laparoscopic low anterior resection (LAR).

Midesophageal diverticulum with elevated intrabolus pressure: a case report.

Background: Esophageal diverticulum is commonly associated with esophageal motility disorders, which can be diagnosed using high-resolution manometry (HRM) according to the Chicago classification. Although midesophageal diverticulum (M-ED) is associated with inflammatory processes, esophageal motility disorders have been recently identified as an etiology of M-ED.

Case Presentation: We present the case of a patient with M-ED and elevated intrabolus pressure (IBP), which did not meet the criteria for esophageal motility disorders according to the Chicago classification.