Publications by authors named "Okumura S"

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).

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

Objectives: In the ninth edition of the TNM classification of lung cancer, N2 is subdivided into single-station (N2a) and multiple-station involvement (N2b), and some stage changes are made to stage II-III. This study aimed to validate the new classification and determine the effect of stage migration and vice versa on the prognosis of each pathological stage due to these changes.

Materials And Methods: A total of 1,754 patients with surgically resected lung cancer were included.

View Article and Find Full Text PDF

Background: In breast reconstruction using the abdominal perforator flap, if the flap capacity is too large, secondary revision procedures can be performed to reduce flap volume and reconstruct the inframammary fold (IMF). We examined the various revision methods and cosmetic results.

Methods: This study included 28 patients who underwent secondary revision among 216 patients who had breast reconstruction using the abdominal perforator flap between April 2012 and March 2019.

View Article and Find Full Text PDF

Background: Atrial fibrillation (AF) and heart failure (HF) often coexist, leading to increased mortality. A cryoballoon-based approach is a potential treatment for patients with HF because of its safety and efficacy.

Objectives: The authors sought to evaluate the optimal timing of cryoballoon ablation after the first clinical diagnosis of AF and its prognosis for patients with HF.

View Article and Find Full Text PDF

Protein phosphorylation is a crucial process in various cellular functions, and its irregularities have been implicated in several diseases, including cancer. Antibodies are commonly employed to detect protein phosphorylation in research. However, unlike the extensive studies on recognition mechanisms of the phosphate group by proteins such as kinases and phosphatases, only a few studies have explored antibody mechanisms.

View Article and Find Full Text PDF

Objective: To develop a training program for bronchial sleeve reconstruction using our previously developed 3-dimensional (3D) operable airway model and evaluate its effectiveness in surgical trainees.

Methods: Eight trainees and 4 faculty surgeons were enrolled. Their right upper lobe sleeve reconstruction procedures were scored by 2 senior surgeons in a blinded fashion on a 5-point Likert scale on the following: airway wall tear, reapplied ligatures, reapplied needles, needle entry and exit, anastomotic bite, and caliber adjustment (full score: 30).

View Article and Find Full Text PDF

Background: The appropriate extent of hilar lymph node (LN) dissection in segmentectomy for lung cancer has not yet been fully investigated. Herein, we assessed the patterns of LN metastasis using network analyses.

Methods: Patients with nodal metastases of non-small-cell lung cancer measuring ≤30 mm in diameter who underwent anatomical resection were included.

View Article and Find Full Text PDF
Article Synopsis
  • New diagnostic criteria have classified small-for-size syndrome (SFSS) after living donor liver transplantation into three severity groups, and this study focuses on grade A SFSS and its mortality risk.
  • Data from 406 patients were analyzed, categorizing them into up-trend, down-trend, and ascites groups based on their bilirubin levels and ascites presence after surgery.
  • While survival rates were similar for SFSS and non-SFSS patients, those in the up-trend group had significantly higher 90-day mortality and should receive aggressive intervention if they have additional risk factors.
View Article and Find Full Text PDF

Background: Facial sensory nerves play vital roles in daily functions like self-protection, facial expressions, speaking, and eating. Severing the infraorbital nerve (ION) during partial maxillectomy via the Weber-Ferguson incision can lead to sensory disturbances. This study presents immediate ION reconstruction using artificial nerve conduits and its short-term outcomes.

View Article and Find Full Text PDF

Background And Objectives: A recent Japanese phase three clinical trial for lung cancer suggested a possible advantage of segmentectomy over lobectomy in terms of death from other diseases. This study aimed to compare the risk of death from other diseases based on surgical procedures in lung cancer patients without recurrence.

Methods: We retrospectively reviewed 2121 patients without disease recurrence after curative resection for lung cancer at our institution.

View Article and Find Full Text PDF
Article Synopsis
  • The study aims to understand the role of the PGE2 receptor EP4 in vascular intimal hyperplasia (IH), noting its differing effects in vascular smooth muscle cells (VSMCs) and endothelial cells.
  • Researchers generated EP4 reporter mice and found that EP4 expression peaks in VSMCs two weeks post-femoral artery injury, affecting IH's progression based on EP4 levels in these cells.
  • The downstream effects of EP4 signaling in VSMCs were explored, revealing that EP4 promotes VSMC proliferation and migration through fibulin-1 and its interaction with ECM1, suggesting that targeting this signaling pathway could be a potential therapeutic approach to manage IH.
View Article and Find Full Text PDF

Living donor liver transplantation (LT) and deceased donor split-LT often result in congestion within liver grafts. The regenerative process and function of congested areas, especially graft congestion associated with LT, are not well understood. Therefore, we created new rat models with congested areas in partially resected livers and orthotopically transplanted these livers into syngeneic rats to observe liver regeneration and function in congested areas.

View Article and Find Full Text PDF

Children with intestinal failure suffer liver damage associated with parenteral nutrition: a condition known as intestinal failure-associated liver disease (IFALD), which requires transplantation of both liver and intestine. In many countries, simultaneous transplantation of these two organs is performed using grafts from a deceased donor, but there have been no such cases in Japan, and the details of the procedure are not clear. Recently, we performed simultaneous split liver and intestinal transplantation in two premature infants with IFALD, using organs from identical deceased donors and achieved good results.

View Article and Find Full Text PDF

Background: Although the outcomes of living donor liver transplantation (LDLT) for pediatric acute liver failure (PALF) have improved, patient survival remains lower than in patients with chronic liver disease. We investigated whether the poor outcomes of LDLT for PALF persisted in the contemporary transplant era.

Methods: We analyzed 193 patients who underwent LDLT between December 2000 and December 2020.

View Article and Find Full Text PDF
Article Synopsis
  • The study focuses on remnant gastric cancer (RGC) which is rare, examining clinical findings, postoperative data, and challenges in its management among 313 patients from 17 Japanese institutions.
  • Results show that a significant portion of patients had early-stage RGC, but disease recurrence rates were notable, especially within the first few years post-surgery, with peritoneal recurrence being the most common.
  • Adjuvant chemotherapy (AC) appeared to improve recurrence-free survival significantly, suggesting that AC might offer similar benefits as in primary gastric cancer despite some limitations in the study design.
View Article and Find Full Text PDF

We developed a surgical support system that visualises important microanatomies using artificial intelligence (AI). This study evaluated its accuracy in recognising the thoracic nerves during lung cancer surgery. Recognition models were created with deep learning using images precisely annotated for nerves.

View Article and Find Full Text PDF

In cattle, bovine respiratory syncytial virus (BRSV) is associated with secondary bacterial infections; however, the mechanisms of the interaction between BRSV and bacteria are unclear. Trueperella pyogenes (T. pyogenes) causes pneumonia in cattle and is involved in secondary infections following viral infections.

View Article and Find Full Text PDF

Background: The indication of living donor liver retransplantation (re-LDLT) for retransplant candidates with chronic allograft failure (CAF) is increasing because of the high mortality rate of patients on the waiting list. However, evidence supporting re-LDLT for CAF remains scarce because of technical difficulties. We aimed to examine the feasibility based on our significant case experience.

View Article and Find Full Text PDF
Article Synopsis
  • Scientists studied patients with a rare disease called methylmalonic acidemia (MMA) who had liver transplants to see how well they did over time.
  • They found that after 10 years, most of the patients were still alive and doing well, especially if they got their transplant within two years of getting sick.
  • However, some patients still had health issues like learning difficulties and kidney problems, but their MMA levels went down a lot after the transplant.
View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF
Article Synopsis
  • Proximal phalanx fractures of the big toe that involve angulation or dislocation require surgical intervention, including repositioning and fixation.
  • A 45-year-old male patient with a left big toe fracture and dislocation was successfully treated using the innovative ICHI-FIXATOR® system, which employs wire-connected external fixation.
  • After surgery, the patient quickly regained the ability to walk, had wires removed four weeks later, and reported no pain during activities eight months post-op, indicating the fixator's effectiveness for toe fracture management.
View Article and Find Full Text PDF
Article Synopsis
  • - The narrative review examines how social media (SoMe) is used for research communication in surgery, highlighting its role in sharing articles and enhancing citation metrics through strategies like visual abstracts.
  • - SoMe is beneficial for surgical education, allowing for the wide sharing of online training videos, though it raises concerns about varying content quality.
  • - Additionally, SoMe enables focused discussions and is increasingly used by general surgery residency programs in the U.S. for recruitment, emphasizing the importance for surgeons to understand its effective use.
View Article and Find Full Text PDF

Unlabelled: WHAT IS KNOWN ON THE SUBJECT?: Recovery-oriented practices in community-based mental health services are of increasing importance. The recovery journey of individuals with mental illness starts with a sense of agency, and a therapeutic relationship with the providers who support them is a prerequisite. In Japan, the construction of community-based integrated care systems for individuals with mental illness is positioned as a priority health issue, with communication with familiar individuals being particularly important for recovery in Japanese and Asian cultures.

View Article and Find Full Text PDF