Clinical outcomes of peripherally inserted central catheters in patients with gastroenterological diseases: Report of a 9-year experience.

Background: Peripherally inserted central catheters (PICCs) are safe and useful alternatives to centrally inserted central catheters (CICCs). Several studies have investigated the effectiveness and safety of PICCs; however, few have focused on their use in patients with gastroenterological diseases. In the present study, we evaluated the outcomes of patients with gastroenterological diseases who received PICCs and identified the risk factors associated with central line-associated blood stream infection (CLABSI).

Ability of minimally invasive surgery to decrease incisional surgical site infection occurrence in patients with colorectal cancer and other gastroenterological malignancies.

Background: Surgical site infection (SSI) is one of the most important complications of surgery for gastroenterological malignancies because it leads to a prolonged postoperative hospital stay and increased inpatient costs. Furthermore, SSI can delay the initiation of postoperative treatments, including adjuvant chemotherapy, negatively affecting patient prognosis. Identifying the risk factors for SSI is important to improving intra- and postoperative wound management for at-risk patients.

Clinical impact of lymphocyte/C-reactive protein ratio on postoperative outcomes in patients with rectal cancer who underwent curative resection.

Cancer-related systemic inflammation influences postoperative outcomes in cancer patients. Although the relationship between inflammation-related markers and postoperative outcomes have been investigated in many studies, their clinical significance remains to be elucidated in rectal cancer patients. We focused on the lymphocyte count/C-reactive protein ratio (LCR) and its usefulness in predicting short- and long-term outcomes after rectal cancer surgery.

Establishment and validation of a nomogram for predicting potential lateral pelvic lymph node metastasis in low rectal cancer.

Background: Identifying lateral pelvic lymph node (LPN) metastasis in low rectal cancer is crucial before treatment. Several risk factors and prediction models for LPN metastasis have been reported. However, there is no useful tool to accurately predict LPN metastasis.

Prognostic Impact of Lateral Pelvic Node Dissection on the Survival of Patients in Low Rectal Cancer Subgroups Based on Lymph Node Size.

Background: Lateral pelvic node (LPN) dissection (LPND) is considered a promising technique for treating low rectal cancer; however, there is insufficient evidence of its prognostic value. Using centrally reviewed preoperative pelvic magnetic resonance (MR) images, this study aimed to find the patient population who has benefited from LPND.

Patients And Methods: MR images of patients from 69 institutes with stage II-III low rectal cancer were reviewed by experienced radiologists.

Preoperative chemoradiotherapy versus surgery alone for advanced low rectal cancer: a large multicenter cohort study in Japan.

Purpose: To clarify the usefulness of chemoradiotherapy (CRT) for low rectal cancer, we investigated the current status of CRT in Japan and its short- and long-term outcomes versus surgery alone for low rectal cancer in a large multicenter cohort study.

Methods: Between January 2010 and December 2011, data from 1608 patients with clinical Stage II-III rectal adenocarcinoma were collected from 69 specialized centers. Of these 1608 patients, 923 were diagnosed with clinical stage III low rectal cancer, 838 were enrolled in this study, divided into the surgery-alone group (n = 649) and preoperative CRT group (n = 189), and analyzed.

Local control of sphincter-preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis.

Sphincter-preserving procedures (SPPs) for surgical treatment of low-lying rectal tumors have advanced considerably. However, their oncological safety for locally advanced low rectal cancer compared with abdominoperineal resection (APR) is contentious. We retrospectively analyzed cohort data of 1500 consecutive patients who underwent elective resection for stage II-III rectal cancer between 2010 and 2011.

Open versus Laparoscopic Surgery for Advanced Low Rectal Cancer: A Large, Multicenter, Propensity Score Matched Cohort Study in Japan.

Background: Laparoscopic surgery for rectal cancer is widely performed all over the world and several randomized controlled trials have been reported. However, the usefulness of laparoscopic surgery compared with open surgery has not been demonstrated sufficiently, especially for the low rectal area.

Objective: The aim of this study was to investigate the hypothesis that laparoscopic primary tumor resection is safe and effective when compared with the open approach for locally advanced low rectal cancer.

Short- and mid-term outcomes after early surgical training in laparoscopic colorectal cancer surgery: trainees' performance has no negative impact.

Background: This study aimed to evaluate the safety and quality of laparoscopic colorectal cancer surgery undertaken by trainees.

Patients And Methods: From a prospectively maintained database, we identified 456 consecutive patients who underwent laparoscopic resection for colorectal cancer between 2006 and 2010. Short-term operative outcomes, relapse-free survival (RFS), and overall survival (OS) were compared between operations undertaken by the experts (E group) and trainees (T group).

Laparoscopic resection for sigmoid and rectosigmoid colon cancer performed by trainees: impact on short-term outcomes and selection of suitable patients.

Purpose: This study aimed (1) to evaluate the impact of clinical factors, particularly operation by trainees, on the short-term outcomes of laparoscopic resection for sigmoid and rectosigmoid cancer, and (2) to determine patients suitable for operation by trainees.

Methods: From a prospectively maintained single-institution database, we identified 133 patients who underwent laparoscopic resection for sigmoid or rectosigmoid cancer between 2007 and 2010. Gender, age, body mass index (BMI), previous abdominal surgery, tumor location, tumor size, tumor stage, extent of lymph node dissection, and primary surgeon were evaluated using univariate and multivariate analyses to determine the predictive significance of these variables on surgical outcomes including operative time, blood loss, complication, postoperative stay, and retrieved lymph nodes.

[Oral capecitabine as postoperative adjuvant chemotherapy in stage III colon cancer patients].

Capecitabine(Xeloda®)has been a global standard drug for the treatment of colon cancer since large randomized controlled trials demonstrated its efficacy and safety in treating patients suffering from the disease. Few studies have been conducted to assess the effects of oral capecitabine treatment on Japanese patients. Therefore, we conducted this study to evaluate oral capecitabine as postoperative adjuvant chemotherapy in 50 patients who underwent surgery for stage III colon cancer at our department.

Evaluation of factors affecting the difficulty of laparoscopic anterior resection for rectal cancer: "narrow pelvis" is not a contraindication.

Background: This study aims to evaluate the clinical and anatomical factors, particularly pelvic dimensions that influence the difficulty of performing laparoscopic anterior resection for rectal cancer.

Methods: We studied 50 consecutive patients who underwent laparoscopic anterior resection with double-stapling technique (DST) anastomosis for rectal cancer between January 2006 and February 2010. Staging was performed by computed tomography.

Factors affecting the difficulty of laparoscopic total mesorectal excision with double stapling technique anastomosis for low rectal cancer.

Background: Although the laparoscopic approach is accepted for the treatment of colon cancer, its value for low rectal cancer is unknown. The purpose of this study was to evaluate the influence of patient and tumor factors, particularly pelvic dimensions, on the difficulties in laparoscopic total mesorectal excision (TME) for low rectal cancer.

Methods: Seventy-nine consecutive patients underwent laparoscopic TME with intracorporeal rectal transection and double stapling technique (DST) anastomosis for low rectal cancer.

Laparoscopic rectal resection for primary rectal cancer combined with open upper major abdominal surgery: initial experience.

Background/aims: Although laparoscopy is accepted for treatment of colon cancer, its use for rectal cancer still has technical limitations. Whether a laparoscopic approach for rectal cancer is safe and beneficial remains unknown when simultaneous open upper major abdominal surgery is planned.

Methodology: Eight patients underwent laparoscopic rectal resection for primary rectal cancer combined with open upper major abdominal surgery.

Short-term outcomes of laparoscopic rectal surgery for primary rectal cancer in elderly patients: is it safe and beneficial?

Purpose: The role of laparoscopic resection in management of rectal cancer is still controversial. The purpose of this study was to evaluate whether laparoscopic rectal resection for rectal cancer could be safely performed in elderly patients.

Methods: Forty-four elderly patients (> or =75 years) undergoing laparoscopic rectal resection (group A) were compared with 228 younger patients (<75 years) undergoing laparoscopic rectal resection (group B) and 43 elderly patients (> or =75 years) undergoing open rectal resection (group C).

Safety of laparoscopic total mesorectal excision for low rectal cancer with preoperative chemoradiation therapy.

Introduction: Total mesorectal excision (TME) with preoperative chemoradiation therapy is an accepted standard treatment for low rectal cancer. Although the laparoscopic approach is accepted for the treatment of colon cancer, its value for low rectal cancer is unknown. The purpose of this study was to evaluate whether preoperative chemoradiation therapy exerted an adverse influence on laparoscopic TME for low rectal cancer.