Is Cholecystectomy Necessary after Choledocholithiasis Treatment for the Elderly or Patients with Many Comorbidities?

Introduction: We evaluated the prognosis after endoscopic treatment for choledocholithiasis, particularly in patients with borderline tolerance to surgery. Stone removal and cholecystectomy are generally recommended for patients with choledocholithiasis combined with gallstones to prevent recurrent biliary events. However, the prognosis after choledocholithiasis treatment in patients with borderline tolerance to surgery, such as the elderly or those with many comorbidities, remains controversial.

Preoperative difficulty assessment of interval laparoscopic cholecystectomy for gallstones.

Background: Laparoscopic cholecystectomy is the gold standard treatment for benign gallbladder disease. However, few studies have reported the difficulty of interval cholecystectomy after cholecystitis because early cholecystectomy is recommended for acute cholecystitis. In this study, we evaluated the difficulties associated with interval cholecystectomy for cholecystitis with gallstones.

Evaluation of Intraoperative Neural Monitoring During Thoracoscopic Surgery for Esophageal Cancer.

Background/aim: Recurrent laryngeal nerve paralysis (RLNP) induces aspiration pneumonia and reduces the patient's quality of life. To decrease the incidence of RLNP, we performed intraoperative neural monitoring (IONM) during thoracoscopic surgery for esophageal cancer and evaluated its usefulness.

Patients And Methods: A total of 737 consecutive patients who underwent thoracoscopic surgery for esophageal cancer were enrolled in this study.

Recurrent Primary Abdominal Wall Abscess: A Case Report and Review of the Literature.

Primary abdominal wall abscess is extremely rare and difficult to diagnose because abdominal wall abscesses usually occur secondary to malignant tumors or inflammatory diseases. We experienced a case of an 80-year-old man with an asynchronous primary abdominal wall abscess with recurrence. Both abscesses were successfully treated with surgical drainage.

Therapeutic strategy for acute appendicitis based on laparoscopic surgery.

Purpose: The treatment strategies for acute appendicitis differ depending on the facility, and various studies have investigated the usefulness of conservative treatment with antibiotics, laparoscopic surgery, and interval appendectomy (IA). However, although laparoscopic surgery is widely used, the clinical strategy for acute appendicitis, especially complicated cases, remains controversial. We assessed a laparoscopic surgery-based treatment strategy for all patients diagnosed with appendicitis, including those with complicated appendicitis (CA).

Usefulness of Preoperative Predictors of Pathological Complicated Appendicitis.

Introduction: Complicated appendicitis (CA) is often indicated for emergency surgery; however, preoperative predictors of pathological CA (pCA) remain unclear. Furthermore, characteristics of CA that can be treated conservatively have not yet been established.

Methods: 305 consecutive patients diagnosed with acute appendicitis were reviewed.

Cardiac metastasis after esophagogastrectomy for esophageal adenocarcinoma with an antemortem diagnosis.

Cardiac metastasis is uncommon and rarely diagnosed antemortem. Here, we describe a case of symptomatic cardiac metastasis from esophageal adenocarcinoma. A 64-year-old man developed chest symptoms 26 months after curative esophagogastrectomy for esophageal adenocarcinoma.

Relationship between GLIM criteria and disease-specific symptoms and its impact on 5-year survival of esophageal cancer patients.

Background & Aims: Malnutrition is common in patients with esophageal cancer, which affects their prognosis. The global leadership initiative on malnutrition (GLIM) criteria was recently proposed as the world's first diagnostic criteria for malnutrition. However, the association between esophageal cancer patients and the GLIM criteria is unclear.

Primary lymphoepithelioma-like carcinoma of the esophagus with metastatic lymph node and gastric cancer.

Upper gastrointestinal lymphoepithelioma-like carcinoma (LELC) is a rare disease-especially esophageal LELC (ELELC). Here, we report a surgically treated case of ELELC with gastric carcinoma. The patient was a 68-year-old asymptomatic Japanese man.

Effect of Postoperative Oral Intake on Prognosis for Esophageal Cancer.

Background: Patients undergoing surgery for esophageal cancer are at risk of prolonged hospital stay for postoperative malnutrition. Postoperative early oral feeing is a part of the "enhanced recovery after surgery protocol" for coping with this risk. However, the usefulness of early oral intake during perioperatively is questionable.

Predictive factors of difficulty of thoracoscopic esophagectomy in the left decubitus position.

Background: We have sometimes experienced technical difficulty performing thoracoscopic esophagectomy because of the position of the descending aorta or width of the mediastinal space. In this study, we retrospectively investigated predictive preoperative factors that influence the procedure of thoracoscopic esophagectomy with a focus on the position of the descending aorta and width of the mediastinal space.

Methods: Ninety-five patients who underwent thoracoscopic esophagectomy for esophageal cancer by two specialists were included in this study.

Preoperative Depressive Mood of Patients With Esophageal Cancer Might Delay Recovery From Operation-Related Malnutrition.

Background: We investigated the relationship between the preoperative psychological state and the perioperative nutritional conditions of patients with esophageal cancer.

Methods: Seventy-three participants underwent operations for esophageal cancer in our hospital. Depressive state was evaluated using the Self-Rating Depression Scale (SDS).

Columnar metaplasia in the remnant esophagus is a long-term indicator for pneumonia after radical esophagectomy.

Background: This study investigated the long-term risk factors for pneumonia after esophageal reconstruction using a gastric tube via the posterior mediastinal route following esophagectomy for esophageal cancer. The influence of columnar metaplasia in the remnant esophagus was specifically assessed.

Methods: Among 225 patients who underwent esophagectomy between January 2004 and December 2010, the subjects were 54 patients who could be followed up for more than 5 years.

Influence of incomplete neoadjuvant chemotherapy on esophageal carcinoma.

Background: Neoadjuvant chemotherapy (NAC) involving two cycles of cisplatin plus fluorouracil is recommended in Japan as a standard treatment for resectable, locally advanced esophageal squamous cell carcinoma (ESCC). We have encountered patients who were administered incomplete chemotherapy because of adverse events or the patient's refusal of treatment. Here, we retrospectively investigated the influence on perioperative outcomes and long-term prognosis of patients with ESCC who underwent complete (two cycles) or incomplete (one cycle) NAC.

Treatment results of neoadjuvant chemoradiotherapy followed by radical esophagectomy in patients with initially inoperable thoracic esophageal cancer.

Purpose: We evaluated the effectiveness of neoadjuvant chemoradiotherapy (CRT) followed by esophagectomy for cT4 esophageal cancer or lymph node metastases (LNM) invading adjacent structures.

Materials And Methods: We retrospectively evaluated 42 consecutive patients with thoracic esophageal cancer who underwent CRT followed by esophagectomy between 2008 and 2013. All were initially considered to be unresectable because of cT4 (n = 32) disease or LN invasion (n = 10).

Relationship Between Muscle Strength Asymmetry and Body Sway in Older Adults.

The purpose of this study was to investigate the relationship between muscle strength asymmetry and body sway while walking. We studied 63 older adult women. Strong side and weak side of knee extension strength, toe grip strength, hand grip strength, and body sway while walking were measured.

Supracarinal dissection of the oesophagus and lymphadenectomy by MIE.

Since 1995, video-assisted thoracoscopic oesophagectomy (VATS), according the same surgical principles as the Japanese open surgery, has been completed in 700 patients with oesophageal cancer. Our indication for VATS is (I) no extensive pleural adhesion; (II) no contiguous tumor spread; (III) pulmonary function capable of sustaining single-lung ventilation, and (IV) non radiated patients. We use 4 ports around a 5 cm mini-thoracotomy on 5th intercostal space.

Safety and feasibility of thoracoscopic esophagectomy after neoadjuvant chemotherapy for esophageal cancer.

Purpose: Neoadjuvant chemotherapy (NAC) with cisplatin and fluorouracil is the recommended standard treatment for resectable locally advanced esophageal cancer (EC) in Japan. We investigated the effects of NAC on the safety and feasibility of thoracoscopic esophagectomy with total mediastinal lymphadenectomy for EC.

Methods: This retrospective study analyzed data from 225 consecutive patients who underwent thoracoscopic esophagectomy with lymph node dissection between April 2007 and December 2015.

Comparison of Short-Term Outcomes Between Open and Minimally Invasive Esophagectomy for Esophageal Cancer Using a Nationwide Database in Japan.

Purpose: This study aimed to compare short-term outcomes of minimally invasive esophagectomy (MIE) with those of open esophagectomy (OE) for thoracic esophageal cancer using a nationwide Japanese database.

Methods: Overall, 9584 patients with thoracic esophageal cancer who underwent esophagectomy at 864 hospitals in 2011-2012 were evaluated. We performed one-to-one matching between the MIE and OE groups on the basis of estimated propensity scores for each patient.

Enteral Diet Enriched with ω-3 Fatty Acid Improves Oxygenation After Thoracic Esophagectomy for Cancer: A Randomized Controlled Trial.

Background: Although the anti-inflammatory effects of immunomodulating diets (IMDs) have recently attracted attention, the efficacy of enteral feeding of such diets after radical surgery remains controversial. Thus, we conducted a new prospective, randomized controlled study to elucidate any beneficial effect of an IMD containing eicosapentaenoic acid (EPA) and γ-linolenic acid (GLA) in patients undergoing radical esophagectomy for thoracic esophageal cancer.

Methods: From November 2009 to July 2011, 87 consecutive patients were randomized to receive either an IMD enriched with EPA, GLA, and antioxidants (n = 42) or a standard isocaloric, isonitrogenous diet (control group, n = 45) after esophagectomy with radical lymphadenectomy.

Incidence of Esophageal Carcinomas After Surgery for Achalasia: Usefulness of Long-Term and Periodic Follow-up.

BACKGROUND Patients with esophageal achalasia are considered to be a high-risk group for esophageal carcinoma, and it has been reported that this cancer often arises at a long interval after surgery for achalasia. However, it is unclear whether esophageal carcinoma is frequent when achalasia has been treated successfully and the patient is without dysphagia. In this study, we reviewed patients with esophageal carcinoma who were detected by regular follow-up after surgical treatment of achalasia.