Publications by authors named "Mitsuru Muto"
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.
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
- - This study focused on understanding portal hypertension (PHT) and its predictors in patients who survived biliary atresia (BA) after undergoing a surgical procedure called Kasai portoenterostomy (KPE).
- - Researchers analyzed data from 320 patients across six centers in East Asia, finding that 37.8% developed PHT by five years post-KPE, particularly those who had the surgery later in life.
- - Key findings revealed that higher bilirubin levels at one year post-KPE are linked to increased PHT risk, highlighting the importance of early surgery and ongoing monitoring for patients showing persistent jaundice.
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)].
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.
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.
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 PDFPurpose: 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.
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.
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- Mucoepidermoid carcinoma, a rare lung cancer in children, can cause obstructive symptoms and lead to lung collapse.
- A case involved a six-year-old girl with recurrent pneumonia due to a mass in her right upper lobe, resulting in a successful lobectomy after confirming the tumor's position with bronchoscopy.
- Intraoperative bronchoscopy proved essential for ensuring complete removal of the tumor while protecting surrounding lung tissue and maintaining respiratory function.
Severely neurologically impaired patients sometimes require anti-reflux surgery with preceding gastrostomy. We apply a traction technique for laparoscopic fundoplication (LF) without gastrostomy takedown (GTD) in such cases. We conducted a multicenter review to assess the feasibility of our approach.
View Article and Find Full Text PDFPurpose: Management of persistently patent ductus arteriosus (PDA) in extremely low-birth-weight infants (ELBWIs) requires attention due to the risk of tissue hypoperfusion. We investigated the association between PDA and gastrointestinal perforation.
Methods: We performed a retrospective chart review from 2012 to 2021.